Correction of the functional state of the autonomous nervous system in the women presenting with the postmastectomy syndrome at the stationary stage of the rehabilitative treatment

Abstract

A frequent consequence of the treatment of breast cancer is the postmastectomy syndrome that combines psycho-emotional and functional disorders in various body systems. Aim. The objective of the present study was to evaluate the influence of the program of differential physical rehabilitation on the functional state of the autonomic nervous system in the women with the postmastectomy syndrome at the stationary stage of the rehabilitative treatment. Patients and methods. The study included 50 presenting with the postmastectomy syndrome following radical mastectomy as described by J.L. Madden. The patients were randomly divided into two groups comprised of 25 patients each. The main group consisted of the women at the mean age of 55,44±1,06 years, the group of comparison (2) was composed of the women at the mean age of 55,60±1,14 years. The program of the rehabilitative treatment of the patients in group 1 envisaged the use of the physical therapeutic modalities chosen on an individual basis in agreement with the basic principles of medical gymnastics including the differential selection of static and dynamic respiratory maneuvers with due regard for the type of vegetative regulation in a given patient, post-isometric relaxation, Vodder’s manual lymphatic drainage and autotraining as described by J.H. Suhultz. The patients comprising the group of comparison performed therapeutic physical exercises as described by T.I. Grushina. The analysis of the literature and empirical data was combined with that of the heart rate variability was measured twice: within days 2—3 after the surgical intervention and on days 19—20 of the hospital stay. The methods of mathematical statistics were employed to treat the data obtained. Results. The study has demonstrated reduced reserves of vegetative support, the overall decrease of the heart rate variability, and enhanced tension of the adaptive mechanisms in this group of women. Moreover, it showed the positive outcome of the physical rehabilitation program designed to correct most of the time-related and spectral parameters of the heart rate variability and gave evidence of the significant improvement of the total activity of the regulatory systems due to the enhancement of the high-frequency, low-frequency and very low-frequency components of the spectrum. The values of the stress index and the mode amplitude were reduced whereas the adaptive capabilities of the autonomic nervous system in women of the main group were extended. Conclusion. The proposed program of differential physical rehabilitation can be employed in the practical work of the specialized healthcare facilities for the correction of the functional state of the autonomic nervous system in the women with the postmastectomy syndrome.