Issue №5-21, 2022

Dynamic Electroneurostimulation in Rehabilitation: a Prospective Randomized Study of 60 Patients after Surgical Treatment of Colorectal Malignancies



1 ORCIDVictor A. Drobyshev, 1 ORCIDLubov A. Shpagina, 2 ORCIDAndrey A. Vlasov, 2 ORCIDMarina V. Umnikova, 3 ORCIDTatyana M. Smarzh

1 Novosibirsk State Medical University, Novosibirsk, Russian Federation
2 “TRONITEK” LLC, Ekaterinburg, Russian Federation
3 City Clinical Hospital No. 2, Novosibirsk, Russian Federation


ABSTRACT

INTRODUCTION. Surgical treatment of colorectal malignancies, while increasing overall survival often determines the persistence ofthe pain syndrome, causing a decrease in the quality of life of patients. Pain-relieving medicines have side-effects and complications,which determines the search for and introduction of non-medicinal technologies.

AIM. To evaluate the effectiveness of incorporating dynamic electroneurostimulation in the rehabilitation of patients after surgicaltreatment for colorectal cancer to correct pain syndrome, autonomic dysfunction and quality of life indices.

MATERIAL AND METHODS. 60 male and female patients aged between 35 and 65 with a verified diagnosis of the colon and rectummalignant neoplasms after surgical treatment were examined in the conditions of the outpatient oncological care center at the StateMedical Institution “City Clinical Hospital No. 2” (Novosibirsk). They were divided into 2 groups: the 1st group (the main group, n=40)in addition to standard therapy received a 15-day course of dynamic electroneurostimulation (DENS) performed with «NEURODENSPCM» device, the 2nd group (the comparison group, n=32) received a standard treatment including chemotherapy, symptomaticpharmacotherapy and exercise therapy. The examination included assessment of pain syndrome using validated pain scales, thevegetative status, anxiety and depression, quality of life parameters.

RESULTS AND DISCUSSION. The patients of the 1st group showed 1.2- and 2.4 times reduction of algias by the 5th and 15th day ofrehabilitation respectively. Upon completion of the rehabilitation the autonomic nervous system balance index (LF/HF) was adjustedby 4.8 and the centralization index by 6.0 times against the baseline, the anxiety and depression index on the HADS scale was reducedby 1.5 times, the quality of life on the SF-36 scale improved: physical functioning by 1.5 times, pain by 1.2 times, general health by 1.5times, which differed from the similar indicators in the 2nd group.Dynamic electroneurostimulation using NEURODENS-PCM device can have pain-relieving and vegetative-regulating effects due toactivation of antinociceptive brain structures and influence on suprasegmental parts of the autonomic nervous system.

CONCLUSION. The inclusion of dynamic electroneurostimulation using «NEURODENS-PCM» device in the rehabilitation of patientsafter surgical treatment of malignant neoplasms in the colorectal region enables a faster relief of pain syndrome, adjustment of theneurovegetative regulation and the anxiety level, which contributes to improvement of the ' quality of life of patients.


KEYWORDS: colorectal neoplasms, cancer, anxiety, depression, quality of life, autonomic nervous system

For citation: Drobyshev V.A., Shpagina L.A., Vlasov A.A., Umnikova M.V., Smarzh T.M. Dynamic Electroneurostimulation in Rehabilitation: a Prospective Randomized Study of 60 Patients after Surgical Treatment of Colorectal Malignancies. Bulletin of Rehabilitation Medicine. 2022; 21 (5): 58-67. https://doi.org/10.38025/2078-1962-2022-21-5-58-67



References:

1. Heinimann K. Erblicher Darmkrebs: Hereditary Colorectal Cancer: Clinics, Diagnostics and Management. Therapeutische Umschau. 2018; 75(10): 601-606. https://doi.org/10.1024/0040-5930/a001046
2. Patel S.G., Karlitz J.J., Yen T., Lieu C.H., Boland C.R. The rising tide of early-onset colorectal cancer: a comprehensive review of epidemiology, clinical features, biology, risk factors, prevention, and early detection. The Lancet Gastroenterology & Hepatology. 2022; 7(3): 262-274. https://doi.org/10.1016/S2468-1253(21)00426-X
3. Khalilov Z.B., Kalinichenko A.Yu., Azimov R.Kh. Minimally invasive surgery for colorectal cancer in elderly and senile patients. Surgery. 2018; (3): 76-81. https://doi.org/10.17116/hirurgia2018376-81
4. Mauri G., Sartore-Bianchi A., Russo A.G., Marsoni S., Bardelli A., Siena S. Early-onset colorectal cancer in young individuals. Molecular Oncology. 2019; 13(2): 109-131. https://doi.org/10.1002/1878-0261.12417
5. Carli F., Bousquet-Dion G., Awasthi R., Elsherbini N., Liberman S., Boutros M., Stein B., Charlebois P., Ghitulescu G., Morin N., Jagoe T., Scheede-Bergdahl C., Minnella E.M., Fiore J.F. Jr. Effect of Multimodal Rehabilitation vs Postoperative Rehabilitation on 30-Day Postoperative Complications for Frail Patients Undergoing Resection of Colorectal Cancer: A Randomized Clinical Trial. JAMA Surgery. 2020; 155(3): 233-242. https://doi.org/10.1001/jamasurg.2019.5474

6. Pavelets K.V., Lobanov M.Yu., Shishlikova Yu.S., Rusanov D.S. Multidisciplinary approach in the surgical treatment of colorectal cancer in elderly and senile patients with high surgical and anesthetic risk. Modern Problems of Science and Education. 2018; (5). Available at: https://science-education.ru/ru/article/view?id=27908 (accessed 09.06.2022).
7. Sacomori C., Lorca L.A., Martinez-Mardones M., Salas-Ocaranza R.I., Reyes-Reyes G.P., Pizarro-Hinojosa M.N., Plasser-Troncoso J. A randomized clinical trial to assess the effectiveness of pre- and post-surgical pelvic floor physiotherapy for bowel symptoms, pelvic floor function, and quality of life of patients with rectal cancer: CARRET protocol. Trials. 2021; 22(1): 448 p. https://doi.org/10.1186/s13063-021-05396-1
8. Order of the Ministry of Health of the Russian Federation «On approval of the Procedure for the provision of palliative care to the adult population» dated April 14, 2015 No. 187n - Text: electronic, GARANT system (accessed 09.07.2022).
9. Mummolo S., Nota A., Tecco S., Caruso S., Marchetti E., Marzo G., Cutilli T. Ultra-low-frequency transcutaneous electric nerve stimulation (ULF-TENS) in subjects with craniofacial pain: A retrospective study. Cranio. 2020; 38(6): 396-401. https://doi.org/10.1080/08869634.2018.1526849
10. Kadochnikova E.Yu., Vlasov A.A., Alekseeva L.I., Dydykina I.G., Ershova O.B., Zaitseva E.M., Korotkova T.A., Popova T.A., Sukhareva M.L., Taskina E.A., Sharapova E.P., Solodovnikov A.G., Lesnya O.M. Efficiency of dynamic electrical nerve stimulation (DENS) in the treatment of knee osteoarthritis (results of a multicenter randomized study). Osteoporosis and Osteopathy. 2016; 19(2): 107-107. https://doi.org/10.14341/osteo20162107-107
11. Ryavkin S.Yu., Ponomarenko G.N., Drobyshev V.A., Shashukov D.A., Vlasov A.A., Vasilenko A.M. The effectiveness of the use of transcutaneous electrical nerve stimulation in discogenic dorsopathies of the lumbar localization. Bulletin of Rehabilitation Medicine. 2012; (5): 2-10.
12. Omochev O.G., Chichilov M.A. Features of the complex effect of electrical neuromyostimulation and acupuncture in lumbosacral dorsopathy. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2018; 17(1): 29-31. https://doi.org/10.18821/1681-3456-2018-17-1-29-31
13. Esin R.G., Esin O.R., Akhmadeeva G.D., Salikhova G.V. Backache. Kazan State Medical Academy of the Federal Agency for Health and Social Development. Kazan. 2010: 272 p.
14. Mukhtarova R.R. Early diagnosis of the cardiovascular form of diabetic autonomic neuropathy. Practical Medicine. 2013; 1-2(69): 75-79.
15. Gainutdinova R.R., Yakupov E.Z., Kazantsev A.Yu. Impact of dizziness on quality of life. Bulletin of Contemporary Clinical Medicine. 2020; 13(2): 30-36. https://doi.org/10.20969/VSKM.2020.13(2).30-36
16. Peng W.W., Tang Z.Y., Zhang F.R., Li H., Kong Y.Z., Iannetti G.D., Hu L. Neurobiological mechanisms of TENS-induced analgesia. NeuroImage. 2019; (195): 396-408. https://doi.org/10.1016/j.neuroimage.2019.03.077
17. Arai Y.C., Ito A., Ohshima K., Hibino S., Niwa S., Kawanishi J., Numanami H., Sakakima Y., Mizuno S., Tawada Y., Maruyama Y., Sato J., Nishihara M., Inoue S., Ushida T. Transcutaneous Electrical Nerve Stimulation on the PC-5 and PC-6 Points Alleviated Hypotensionafter Epidural Anaesthesia, Depending on the Stimulus Frequency. Evidence-Based Complementary and Alternative Medicine. 2012; (2012): 727121. https://doi.org/10.1155/2012/727121






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