Therapeutic physical factors as part of outpatient medical rehabilitation for patients after colorectal cancer surgery: а randomized controlled trial

BACKGROUND: The comprehensive use of therapeutic physical factors in rehabilitation programs contributes to improving the effectiveness of therapeutic measures by favorably influencing sanogenesis processes. AIM: To evaluate the effectiveness of an outpatient medical rehabilitation program for patients after colorectal cancer surgery using therapeutic physical factors. MATERIALS AND METHODS: An open-label, randomized, controlled prospective study included 126 patients who underwent colorectal cancer surgery. Using simple randomization, the patients were divided into three groups. In Comparison group 1 (n=40), rehabilitation followed the Russian guidelines (individual therapeutic exercise and pinaverium bromide). In Comparison group 2 (n=43), in addition to the rehabilitation measures of Group 1, patients received low-mineralized mineral water “Psyz.” In the Main group (n=43), patients received transcutaneous electrical nerve stimulation in the area of the cervical sympathetic ganglia in addition to Group 2 rehabilitation program. The effectiveness of rehabilitation measures was assessed using clinical symptom evaluation based on the Edmonton Symptom Assessment System (ESAS) and quality of life assessment with the European Quality of Life Questionnaire (EQ-5D). RESULTS: Statistical analysis demonstrated that incorporating therapeutic physical factors into outpatient medical rehabilitation programs for patients after colorectal cancer surgery significantly reduced clinical symptoms according to the ESAS scale (p 0.01) and improved quality of life indicators according to the EQ-5D scale, particularly in the Daily Activities (p 0.01), Pain and Discomfort (p 0.01), and Anxiety and Depression (p 0.01) domains. Meanwhile, the positive changes in the studied parameters were, on average, 12–15% lower (p 0.05) in Comparison group 1 and 8–10% lower in Comparison group 2 compared with the Main group. CONCLUSION: The inclusion of therapeutic physical factors in outpatient medical rehabilitation programs for patients after colorectal cancer surgery leads to a significant improvement in quality of life.