RESUMEN
Postmastectomy syndrome (PMS) is a complex neurovascular set of symptoms that develops in most patients after breast cancer (BC) treatment and significantly reduces the quality of life. One of the potential mechanisms of its occurrence is considered to be an endothelial dysfunction. The possible method of reducing manifestation of endothelial dysfunction is systematic aerobic dynamic training. OBJECTIVE: To evaluate the influence of 12-week aerobic dynamic training program of moderate intensity on the endothelial dysfunction laboratory markers and life quality in patients with PMS. MATERIAL AND METHODS: Single-center prospective randomized trial included 40 patients with PMS divided into study (20 patients) and comparative (20 patients) groups, as well as 20 healthy female volunteers. The expression level of soluble intercellular adhesion molecule-1 (ICAM-1) and platelet endothelial cell adhesion molecule-1 (PECAM-1) were evaluated in all participants at baseline by enzyme-linked immunosorbent assay method, and additionally psychological and physical component of health by SF-36 questionnaire were assessed in patients with PMS.Patients of study group received a course of 12-week partially controlled aerobic dynamic training of moderate intensity lasting 45 minutes with frequency equal 5 times per week. Patients with PMS were re-evaluated for ICAM-1 and PECAM-1, as well as for life quality. RESULTS: The group of patients with PMS after BC treatment had increased level of ICAM-1 in long-term period, that may indicate endothelial dysfunction. Statistically significant decrease of endothelial dysfunction laboratory markers was revealed in patients with PMS, who underwent the course of cardiorespiratory training. In the same time, the dynamics of changes in ICAM-1 was higher in the study group than in comparative group. Further, improvement of physical and psychological components of health by SF-36 questionnaire was found. CONCLUSIONS: The program of cardiorespiratory trainings of moderate intensity in patients, who had BC treatment a year ago, decreases intercellular adhesion molecules level that may show an improvement of endothelial dysfunction.
Asunto(s)
Molécula 1 de Adhesión Intercelular , Mastectomía , Humanos , Femenino , Molécula 1 de Adhesión Intercelular/sangre , Persona de Mediana Edad , Adulto , Molécula-1 de Adhesión Celular Endotelial de Plaqueta/sangre , Calidad de Vida , Estudios Prospectivos , Terapia por Ejercicio/métodos , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/rehabilitaciónRESUMEN
Dyscirculatory encephalopathy is a complex of functional and structural changes in the brain that occur against the background of chronic insufficiency of cerebral blood flow. The high prevalence of this pathology, as well as a pronounced impact on the quality of life and working capacity of patients, determines the importance of optimizing rehabilitation measures and developing the most promising strategies for physical rehabilitation. OBJECTIVE: To compare the effectiveness of a special complex of therapeutic (vestibular) gymnastics and training with biofeedback (BFB) on a stabiloplatform in the rehabilitation of patients with dyscirculatory encephalopathy with vestibulo-atactic syndrome. MATERIAL AND METHODS: A cohort prospective single-center randomized comparative study of the clinical effectiveness of the author's complex of therapeutic exercises and stabilometric training with BFB in the complex treatment of patients with dyscirculatory encephalopathy with vestibulo-atactic syndrome was carried out. The study involved 40 patients aged 65-89 years who were randomized into 2 equal groups. Patients of the 1st group, against the background of drug therapy and physiotherapy, were trained on a stabiloplatform with BFB (a training game according to the manufacturer's instructions). Patients of the 2nd group performed a complex of therapeutic (vestibular) gymnastics specially designed for this study. The effectiveness of physical rehabilitation was assessed by the dynamics of (1) subjective symptoms (complaints of patients), (2) indicators of stabilometry (symmetry index, the sum of the coordination indices for the right and left legs, fluctuation) and (3) the results of functional testing using the Get up and go test, the Berg balance scale and the Tinetti mobility scale. RESULTS: In the group of patients who performed vestibular gymnastics, in contrast to patients who participated in training using a multifunctional stabiloplatform with BFB, a statistically significant improvement was revealed when assessed by the Get up and go test and the Berg balance scale. In none of the groups, a distinct dynamics of stabilometry indicators was registered. No correlation was found between the main indicators of stabilometry and the data of functional tests. CONCLUSION: Thus, vestibular gymnastics has demonstrated greater effectiveness in the rehabilitation of patients with dyscirculatory encephalopathy and vestibulo-atactic syndrome in comparison with stabilometric training with biofeedback. The discrepancy between stabilometry indicators and the results of functional testing in patients requires a targeted study.