ADHERENCE TO PHYSICAL REHABILITATION AND RECOVERY OF FUNCTIONAL ACTIVITY AFTER GASTRIC CANCER SURGERY

Introduction. Muscle strength and functional activity often decline after surgery for gastric cancer, and physical rehabilitation is an important means of restoring them. However, how fully patients complete the prescribed exercise program and how this affects outcomes remain insufficiently studied.

Aim. To assess the association between adherence to a physical rehabilitation program and muscle strength and functional activity after surgical treatment of gastric cancer.

Materials and methods. This observational study included 334 patients with histologically confirmed gastric cancer who underwent surgery in 2021–2025. The program comprised early mobilization, breathing exercises, graded walking and resistance training. Patients who completed at least 80% of the program (n=194) were compared with those who completed less (n=140). Time to mobilization, pneumonia rate, handgrip strength at 3 and 6 months, and physical functioning, fatigue (EORTC QLQ-C30) and ECOG performance status at 6 months were assessed.

Results. In the high-adherence group, mobilization was earlier (2.4±0.3 vs 4.1±0.5 days; p<0.01) and pneumonia was less frequent (4.1% vs 10.7%; p=0.019). At 3 months, the difference in handgrip strength did not reach statistical significance (26.4±1.8 vs 22.1±1.5 kg; p=0.067), whereas at 6 months it was significant (29.8±2.1 vs 23.4±1.7 kg; p<0.05). Physical functioning was 78.4±4.2 vs 62.1±3.9 points (p<0.01), fatigue 24.3±2.2 vs 41.6±3.5 points (p<0.001), and the proportion of patients with ECOG 0–1 was 86.6% vs 70.0% (p<0.001).

Conclusion. High adherence to physical rehabilitation is associated with better recovery of muscle strength and physical functioning and less fatigue at 6 months. Regular monitoring of program completion and identification of barriers to adherence are advisable.