Physiotherapy Based on PNF Concept for Elderly People After Conventional Colon Surgery

• Authors: Piotr Czyżewski , Marek Szczepkowski , Janusz Domaniecki , Aneta Dąbek
• Languages of publication: EN

Abstracts

EN

Aging population, increases the number of major abdominal surgery (MAS) performed in the elderly. Main goal of physiotherapy after that surgery is prevention postoperative complications and reduction of functional limitation. The aim of the study was to asses functional status elderly people after MAS during early postoperative physiotherapy. Material and methods. In a prospective randomized study involved 34 patients scheduled for elective MAS, aged 65+. Patients were randomly assigned to receive PNF or conventional physiotherapy. The study included forced spirometry (FVC, FEV1, PEF) and functional tests (gait speed, up&go). Measurements were performed before surgery and the fourth day after surgery. Also analyzed age, sex, BMI and the level of postoperative independence (postoperative independence scale SAP). Kolmogorow- Smirnow test was used to check normal distribution, t-Student was used to check whether two sets of data differ significantly, and r-Pearsons for correlations testing. p values <0.05 were considered significant. Results. After surgery the time of gait speed test and up and go test was significant longer in comparison to preoperative value. FVC%, FEV1%, PEF% values was decrease. In the PNF group was found significantly higher postoperative independence(SAP) and shorter length of stay in hospital compared to conventional physiotherapy group. Results of SAP and functional tests were significantly positive correlated. Conclusions. Major abdominal surgery decrees efficiency of walking and lung ventilation after 65 year old in early postoperative period. Some techniques of the PNF concept used in improving older patients after the MAS may favourably affect the postoperative increase independence and reduce the time of hospitalization.

Keywords

EN

physiotherapy; colorectal surgery; elderly people; PNF (proprioceptive neuromuscular facilitation); functional status

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 9
• Pages: 475-482

Dates

published

1 - 09 - 2013

online

15 - 10 - 2013

Contributors

author

Piotr Czyżewski

• Chair of Rehabilitation, Academy of Physical Education J. Piłsudski in Warsaw, Kierownik: dr hab. M. Łukowicz, prof. nadz. AWF
• Department of General and Colorectal Surgery, Bielański Hospital in Warsaw, Kierownik: dr hab. M. Szczepkowski, prof. nadz. AWF

author

Marek Szczepkowski

• Chair of Rehabilitation, Academy of Physical Education J. Piłsudski in Warsaw, Kierownik: dr hab. M. Łukowicz, prof. nadz. AWF
• Department of General and Colorectal Surgery, Bielański Hospital in Warsaw, Kierownik: dr hab. M. Szczepkowski, prof. nadz. AWF

author

Janusz Domaniecki

• Chair of Rehabilitation, Academy of Physical Education J. Piłsudski in Warsaw, Kierownik: dr hab. M. Łukowicz, prof. nadz. AWF

author

Aneta Dąbek

• Chair of Rehabilitation, Academy of Physical Education J. Piłsudski in Warsaw, Kierownik: dr hab. M. Łukowicz, prof. nadz. AWF

References

• 1. Rutkowska L: Trwanie życia w 2010 roku. Informacje i Opracowania Statystyczne GUS; Warszawa 2011.
• 2. Stańczak J, Zajewska A:. Stan i struktura ludności oraz ruch naturalny w przekroju terytorialnym w 2010 roku, stan w dniu 31 XII. Informacje i Opracowania Statystyczne GUS; Warszawa 2011.
• 3. Waligórska M, Brustman A, Kostrzewa Z i wsp.: Prognoza ludności na lata 2008-2035. Departament Badań Demograficznych GUS; Warszawa 2009.
• 4. Binda A, Kamiński P: Leczenie chirurgiczne powikłań choroby uchyłkowej jelita grubego - doświadczenia własne. Post N Med 2009; 3: 195-203. nal surgery in the elderly. Indian J PhysiotherOccup Ther 2009; 3(3): 49-54.
• 5. Koroukian SM, Murray P, Madigan E: Comorbidity, disability and geriatric syndromes in elderly cancer patients receiving home health care. JClin Oncol 2009; 24: 2304-10.
• 6. Kamiński P: Rak jelita grubego u chorych w podeszłym wieku - leczenie chirurgiczne. Post N Med 2008; 11: 740-45.
• 7. Lee L, Jannapureddy M, Albo D: Outcomes of Veterans Affairs patients older than age 80 after surgical procedures for colon malignancies. Am JSurg 2007; 194: 646-51.[Crossref]
• 8. Krzemieniecki K: Znaczenie całościowej oceny geriatrycznej w onkologii Gerontol Pol 2009; 17(1): 1-6.
• 9. Lawrence VA, Hazuda HP, Cornell JE et al.: Functional independence after major abdominal surgery in the elderly. J Am Coll Surg 2004; 199: 762-72.
• 10. Czyżewski P, Szczepkowski M, Domaniecki JM: Rola fizjoterapii w strategii wczesnego uruchamiania( Fast Track Surgery) po operacjach jelita grubego. Proktologia 2009; 2(10): 117-23.
• 11. Schwenk W, Neudecker J, Raue W et al.: „Fasttrack” rehabilitation after rectal cancer resection. Int J Colorectal Dis 2006; 21(6): 547-53.[Crossref]
• 12. Basse L, Thorbol J, Kehlet H: Colonic surgery with accelerated rehabilitation or conventional care. Dis Colon Rectum 2004; 47: 271-78.[Crossref][PubMed]
• 13. Basse L, Jakobsen DH, Bardram L et al.: Functional recovery after open versus laparoscopic colonic resection: a randomized, blinded study. AnnSurg 2005; 241(3): 416-23.
• 14. Kaba A, Detroz BJ, Laurent SR et al.: Acute rehabilitation program after laparoscopic colectomy using intravenous lidocaine. Acta Chir Belg 2005; 105: 53-58.[PubMed]
• 15. Taher AM, Mohamed MA, Mohga SR : Effect of exercise on functional independence after abdomi-nal surgery in the elderly. Indian J PhysiotherOccup Ther 2009; 3(3): 49-54.
• 16. Ribeiro S, Gastaldi AC, Fernandes C: The effect of respiratory kinesiotherapy in patients undergoing upper abdominal surgery. Einstein 2008; 6(2): 166-69.
• 17. Basse L, Billesbolle P, Kehlet H et al.: Early recovery after abdominal rectopexy with multimodal rehabilitation. Dis Colon Rectum 2002;45: 195-99.[Crossref]
• 18. Mackiewicz-Milewska M, Mackiewicz Z, HagnerW: Problemy rehabilitacyjne chorych z dużymi przepuklinami brzusznymi. Chir Pol 2007; 9(4): 231-36.
• 19. Pasquina P, Tramer MR, Granier JM et al.: Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery: a systematic review. Chest 2006; 130(6): 1887-99.[Crossref][PubMed]
• 20. Simren M.: Physical activity and the gastrointestinal tract. Eur J Gastroenterol Hepatol 2002; 14: 1125-32.
• 21. Kehlet H, Buchler MW, Beart RW et al.: Care after colonic operation -is it evidence-based? Results from a multinational survey in Europe and the United States. J Am Coll Surg 2006; 202: 45-54.
• 22. Vlug MS, Bartels SA , Wind J et al.: Which fast track elements predict early recovery after colon cancer surgery. Colorectal Dis 2012; 14(8): 1001-08.[PubMed][WoS][Crossref]
• 23. A dler SS , Beckers D, Buck M: PNF w praktyce. wyd.3, DB Publishing. Warszawa 2009.
• 24. Ferber R, Gravelle DC, Osternig LR: Effect of proprioceptive neuromuscular facilitation stretch techniques on trained and untrained older adults. J Aging Phys Act 2002; 10: 132-42.
• 25. Klein DA, Stone WJ, Phillips WT et al.: PNF training and physical functionin assisted-living older adults. J Aging and Phys Act 2002; 10: 476-88.

Identifiers

DOI

10.2478/pjs-2013-0074