DYNAMICS OF THE LEVEL OF FUNCTIONING OF MIDDLE-AGED PATIENTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY IN THE POST-ACUTE REHABILITATION PERIOD

Abstract

Aim is to determine the dynamics of the level of functioning of activity and participation of middle- aged patients with acute calculous cholecystitis (ACC) and chronic calculous cholecystitis (CCC) after laparoscopic cholecystectomy (LCC) in the post-acute rehabilitation period and the effectiveness of the developed individual rehabilitation programs. Methods. Middle-aged patients aged 45 to 59 years with CCC (n=40) and patients with ACC (n=40) who underwent laparoscopic cholecystectomy in the surgical department of the Ivano-Frankivsk Central City Clinical Hospital (IFCCH) in 2019–2020 were included. They were assessed for functional impairment, activity, and participation using the International Classification of Functioning (ICF). The study was simple, randomised, with blinded assessors during the interview, examination and data processing. Exclusion criteria: the presence of neuropsychiatric pathology in patients; refusal of patients to participate in the study. There were no dropouts from the study. Statistical methods included measurement of the median value (Me), upper and lower quartiles (25%; 75%). The Mann-Whitney U-test was used to compare independent samples, and the Wilcoxon T-test was used for dependent samples, differences at p<0,05 were considered statistically significant. Results. In patients of MG1 and MG2, a statistically significant difference was found in the level of dysfunctions and limitations in sleep function, emotional function, pain, respiratory function, fatigue, bowel function, trunk muscle strength, washing of body parts, control over diet and physical fitness in comparison with before and after rehabilitation, which indicates the effectiveness of the implemented individual rehabilitation programs in the subacute stage of rehabilitation. Conclusions. In the post-acute period of rehabilitation under the influence of individual rehabilitation programs for middle-aged patients after LCC aimed at solving specific short-term and long-term goals aimed at activity and participation lasting 21 days can positively affect the reduction of dysfunctions and limitations in such indicators as: sleep function, emotions, respiratory function, fatigue, defecation function, washing of body parts, control over diet and physical fitness. For patients after LCC with decreased trunk muscle strength, exercise tolerance, digestive function, muscle endurance, and long-distance walking, it is necessary to continue rehabilitation interventions for long-term rehabilitation periods.