Аssessment of disorders of statodynamic function due to oncological diseases of the brain in comparison with other locations of neoplasms in the medical and social system

Abstract

BACKGROUND: Studies have shown that, in 2019, malignant neoplasms were the major cause of adult disability in the Russian Federation. Thus, it is important to study functional disorders in this group of patients. AIM: To conduct a comparative analysis of the degree of statodynamic impairment caused by malignancies, based on the location of the neoplasm, the tumor stage, and complications. Further, to justify the need for specialized diagnostic equipment for objectively analyzing the degree of statodynamic dysfunction. MATERIALS AND METHODS: A prospective study was carried out on a group of disabled people aged 18 years and older, with malignant neoplasms (ICD code10: C00C97). These patients were initially recognized as disabled, and had further assessment of their degree of disability by the Bureau of Medical and Social Expertise of the Republic of Mordovia. The specialized diagnostic equipment used by the office for expert and rehabilitation diagnostics to assess impairment of statodynamic function was an ergometer with a diagnostic track and a power platform ZEBRIS FDM-T, N/R COSMOS. Indicators were analyzed using a software module which assess the degree of the musculoskeletal and nervous system dysfunction. We performed the collection and processing of data, and a comparative analysis. We also conducted an expert assessment of the dependence of the impairment of statodynamic functions on the main and concomitant diseases, and their complications. RESULTS: The analysis of statodynamic functions in cancer patients showed that the patients with impaired statodynamics averaged 11.24% of the study population. The proportions according to tumor type were 72.4% for malignant neoplasms of bones and articular cartilage, to 5.06% for malignant neoplasms of the thyroid gland and pheochromocytoma. A high percentage of patients with impaired statodynamic function had malignancies of the brain, spinal cord and meninges (C70C72), 41.7%. In cases of malignant neoplasms that were inaccurately designated, secondary, and were unspecified localizations or with metastases without an identified primary focus after radical treatment (C76C80) the proportion was 40.0% relative to the group with these diagnoses. Due to complications of the underlying disease, pronounced and significantly pronounced impairment of statodynamic functions were found in the C70C72 International Classification of Diseases, 10th revision (ICD-10) codes, which correspond to neoplasms of the brain, cerebellum, and spinal cord. Significantly expressed and moderate disorders were found in the C64C68 ICD-10 codes, corresponding to malignant neoplasms of the kidney, renal pelvis, and bladder. Moderate and insignificant dysfunctions of statodynamics were detected in C50, malignant neoplasm of the mammary gland. CONCLUSION: The chronic impairments of statodynamic function in cancer patients are most pronounced in cancers of bone and articular cartilage, and the brain and spinal cord. The prognosis of patients with malignant neoplasms depends on the stage of the disease, the site of the neoplasm, and the initial treatment. Relapses, tumor metastases, and complications of therapy play an important role in the functional disorders seen during follow up. High-tech diagnostic equipment such as ZEBRIS FDM-T, H/R COSMOS allows accurate clinical assessment of the functions associated with movement. This provides an objective basis for the clinical and expert classification of the severity of impaired statodynamic functions of the body.