Colorectal cancer postoperative composite motion-based rehabilitation training acceleration method

Abstract

The invention discloses a method for accelerating rehabilitation training based on compound movement after a colorectal cancer operation, and particularly relates to the technical field of rehabilitation after the colorectal cancer operation. The method comprises the following steps: S1, screening and grouping patients: selecting patients with colorectal cancer which are subjected to surgical treatment and voluntarily participate, screening out patients meeting specific conditions, and randomly dividing the patients into a movement intervention group and a conventional nursing group; and further randomly dividing the motion intervention group into a plurality of small groups, and respectively carrying out composite motion of different combinations. By combining aerobic exercise (gradually increasing walking distance after operation) with specific part exercise (ankle pump exercise and Kegel exercise), the first-time anus exhaust time of an exercise intervention group is advanced by 12.3 hours, the defecation time is shortened by 9.8 hours, the intestinal obstruction occurrence rate is reduced by 67%, meanwhile, the walking distance is increased by 25% in 6 minutes, gastrointestinal motility and body activity recovery are remarkably promoted, and the treatment effect is good. The effect of accelerating the recovery of the gastrointestinal function postoperative body function after the colorectal cancer operation is achieved.

Description

Technical Field

[0001] The present invention relates to the technical field of postoperative rehabilitation of colorectal cancer. More specifically, the present invention relates to a method for accelerating rehabilitation training by compound exercise based on postoperative colorectal cancer. Background Art

[0002] Colorectal cancer is one of the most common malignant tumors in China, and its incidence and mortality have been remaining high, seriously threatening people's lives and health. In recent years, enhanced recovery after surgery (ERAS) has been rapidly developed in the clinical treatment and nursing fields of colorectal cancer. ERAS is a specially designed multimodal perioperative care pathway, and early postoperative exercise is one of the important links in ERAS. Early postoperative exercise can effectively improve the exercise tolerance and tissue oxygenation of colorectal cancer patients after surgery, promote the recovery of gastrointestinal function, and reduce the occurrence of postoperative complications such as hypotension. At the same time, respiratory function training is also the key content of fast-track surgery nursing. Respiratory function exercise can significantly improve the lung function of patients, enhance the patients' tolerance to surgery, and reduce the incidence of postoperative complications. However, the current postoperative rehabilitation means still have certain limitations. Traditional rehabilitation methods often focus on single-dimensional training, such as simple respiratory training or simple limb activities, and have limited effects in improving patients' respiratory function and promoting overall rehabilitation. Moreover, most patients lack professional and systematic rehabilitation guidance, resulting in uneven rehabilitation effects. As a comprehensive physical activity method, compound exercise has shown an important role in the rehabilitation of various chronic diseases and has received extensive attention. Some researchers have applied the six-word formula cardiopulmonary rehabilitation breathing training exercise to patients after colon cancer surgery, and the results show that this training exercise can indeed promote ventilation in patients, relieve dyspnea symptoms, and improve the exercise endurance and quality of life of patients. However, at present, the application of compound exercise in the postoperative rehabilitation of colorectal cancer lacks a systematic and standardized plan, and no unified standards have been formed for the key elements such as the specific combination, intensity, and frequency of compound exercise.

[0003] Colorectal cancer patients often face many problems that affect respiratory function after surgery: 1. Surgical incision pain is a common symptom after surgery. The pain will limit the patient's ability to take deep breaths and cough effectively, resulting in shallow and rapid breathing and reduced lung ventilation volume; 2. Colorectal cancer surgery is usually performed in the abdomen. Postoperative abdominal incision and muscle damage will destroy the integrity and muscle function of the abdomen. The abdominal muscles play a key role in respiratory movement. In particular, the impairment of the strength of the diaphragm and intercostal muscles will lead to weakened respiratory strength in patients; 3. After surgery, patients need to stay in bed for a long time and their activity levels are greatly reduced. This will slow down the body's blood circulation, and the blood circulation in the lungs will also be affected, easily causing pulmonary congestion. The limitation of abdominal muscle function will also lead to a decrease in the patient's ability to cough and expectorate phlegm, increasing the risk of complications such as atelectasis and pulmonary infection.

[0004] Regarding the above problems, compound exercise may play a positive role through the following mechanisms: Improve pulmonary ventilation function: Compound exercise can help patients overcome pain limitations, guide patients to perform more effective deep breathing and coughing, thereby increasing pulmonary ventilation volume, increasing vital capacity and lung elasticity, and improving oxygen exchange efficiency; Enhance respiratory strength and endurance: Through targeted exercise training, it helps to restore the function of abdominal muscles, especially enhance the strength of the diaphragm and intercostal muscles, and then improve the patient's respiratory strength and endurance; Promote blood circulation: Compound exercise can promote blood circulation throughout the body, improve the blood circulation condition of the lungs, reduce the occurrence of pulmonary congestion, improve the oxygen distribution and utilization efficiency in the body, and thus enhance the oxygenation level of the whole body; Reduce the risk of postoperative complications: Compound exercise helps to improve the patient's ability to cough and expectorate phlegm, reduce the occurrence of complications such as atelectasis and pulmonary infection, and help the patient quickly recover normal respiratory function.

[0005] In summary, there is an urgent need for a scientific, systematic, and standardized compound exercise accelerated rehabilitation training method based on colorectal cancer surgery to solve the problems existing in the rehabilitation process of colorectal cancer surgery and improve the rehabilitation effect and quality of life of patients. Summary of the Invention

[0006] The purpose of the present invention is to provide a method for compound exercise accelerated rehabilitation training based on colorectal cancer surgery to solve the problems of decreased respiratory function, gastrointestinal dysfunction, high incidence of postoperative complications, and poor rehabilitation effect caused by the lack of individualized compound exercise programs, single existing rehabilitation means, and unclear key parameters and action mechanisms in the existing colorectal cancer surgery.

[0007] To achieve the above purpose, the present invention provides the following technical solution: A method for compound exercise accelerated rehabilitation training based on colorectal cancer surgery, including the following steps; S1. Patient screening and grouping: Select colorectal cancer patients who have undergone surgical treatment and are willing to participate, screen out patients who meet specific conditions, and randomly divide them into an exercise intervention group and a routine care group; further randomly divide the exercise intervention group into several groups and carry out different combinations of compound exercises; S2. Exercise plan formulation and implementation: 2.1 Aerobic exercise: According to the postoperative recovery stage of the patient, gradually increase the activity time and walking distance, and at the same time perform warm-up and relaxation training before and after exercise; 2.2 Specific part exercise: Carry out exercise training on specific parts such as ankle pump exercise and Kegel exercise according to different surgical conditions; 2.3 Pulmonary function exercise: Pulmonary function exercise is carried out by means of cough training, blowing balloons, using a respiratory trainer, etc.; 2.4 Resistance training: Resistance training is carried out using tools such as elastic bands, including a variety of action combinations; 2.5 Traditional Chinese medicine exercise: Traditional Chinese medicine exercise methods such as Bajie exercise and Baduanjin are introduced; S3. Control of the timing and indications of exercise intervention: Clearly define the indications for starting and stopping exercise to ensure that exercise is carried out within the range allowed by the patient's physical condition; S4. Evaluation of rehabilitation effect: Evaluate from multiple aspects such as postoperative recovery indicators, surgical complications, exercise ability and cardiopulmonary endurance, respiratory function, stress hormones and inflammatory indicators, and record relevant data; S5. Data processing and program optimization: Use statistical software to analyze the evaluation data, and optimize and adjust the rehabilitation training method according to the analysis results.

[0008] Preferably, in the patient screening and grouping step, 80 patients are screened out, with 40 patients in each of the exercise intervention group and the conventional nursing group. The exercise intervention group is equally divided into 4 groups.

[0009] Preferably, in the step of controlling the timing and indications of exercise intervention, the indication for starting exercise is: clear consciousness, stable vital signs, limb muscle strength > 3 levels, Changhai pain scale pain score < 4 points, no oozing or fluid leakage from the incision, no discomfort after sitting on the edge of the bed for 5 minutes, completion of sitting activities, and no orthostatic intolerance after standing for 1 - 3 minutes; The indication for stopping exercise is: Changhai pain scale pain score > 4 points during rest, heart rate > 100 beats / min or < 40 beats / min, blood oxygen saturation < 90%, systolic blood pressure < 90 mmHg and / or diastolic blood pressure < 50 mmHg, presence of fever, excessive oozing or fluid leakage from the wound, and orthostatic intolerance symptoms, weakness during activity, and Changhai pain scale pain score > 5 points when getting out of bed and moving.

[0010] Preferably, in the aerobic exercise step, assist the patient to take a semi - recumbent position and perform in - bed activities 6 hours after anesthesia is awake on the day after surgery, and turn the patient over and pat the back every 2 hours; Assist the patient to get out of bed and move for 1 hour on the first day after surgery, with a minimum walk of 1000 meters and 2000 steps; On the second day after surgery, the patient moves for 1 - 2 hours, with a minimum walk of 1300 meters and 2600 steps; On the third day after surgery, the patient moves for 3 - 4 hours, with a minimum walk of 1600 meters and 3200 steps; One week after surgery, the patient moves for 5 - 6 hours, with a minimum walk of 3000 meters and 6000 steps, and 5 - minute warm - up and relaxation training are carried out before and after exercise.

[0011] Preferably, during the specific part movement step, when the patient does not get out of bed on the day after surgery, ankle pump exercise is performed for 5 to 10 minutes. For patients with tumors invading the bladder and undergoing bladder surgery, Kegel exercises are carried out 14 days after surgery, contracting the muscles for 5 seconds, holding for 5 seconds, relaxing for 10 seconds, and repeating 10 times as a group, 3 to 4 groups per day.

[0012] Preferably, in the pulmonary function exercise step, it includes cough training, balloon blowing training, and using a respiratory trainer: During cough training, the patient takes a sitting or semi-sitting position, feet on the ground, head slightly forward, takes a deep breath and holds for 1 to 2 seconds, and then coughs forcefully. During balloon blowing training, blowing a balloon with a capacity of 500 mL until the diameter reaches 10 cm and holding for 5 seconds is considered an effective exhalation. When using a respiratory trainer, take a comfortable standing or sitting position, blow until the preset scale, hold your breath for 2 to 3 seconds, exhale through pursed lips and remove the trainer. Each group has 20 to 30 times, 1 to 2 groups each time, 2 to 3 times a day, and 15 to 30 minutes each time.

[0013] Preferably, in the resistance training step, a suitable elastic band is selected. Each group includes four actions: standing shoulder press, standing curl, standing chest press, and forceful lift. Each action is performed 10 to 12 times, with a 2-minute rest interval between actions, 15 to 30 minutes each time, and 2 to 3 times a day.

[0014] Preferably, in the traditional Chinese medicine exercise step, traditional Chinese medicine exercises such as Bajie exercise and Baduanjin are performed 2 times a day, 15 to 20 minutes each time.

[0015] Preferably, in the rehabilitation effect evaluation step, the postoperative recovery index evaluation includes the time of first anal exhaust, the time of first defecation, the time of first getting out of bed, the manifestation of cancer-related fatigue, heart rate variability (HRV), etc. The surgical complications are recorded according to the Clavien-Dindo grading standard for complications of grade II and above. The evaluation of motor ability and cardiopulmonary endurance uses the six-minute walk test and the modified Barthel index rating scale. The respiratory function is measured using a pulmonary function tester to measure the maximum ventilation volume, alveolar ventilation volume, respiratory rate, forced vital capacity, tidal volume, and vital capacity. The stress hormones and inflammatory indicators are detected by taking blood to detect indicators such as white blood cell count, C-reactive protein, procalcitonin, cortisol, interleukin 6, and tumor necrosis factor α.

[0016] Preferably, in the data processing and protocol optimization step, statistical software such as SPSS, 9CHISS, and SAS is used to analyze the evaluation data.

[0017] The technical effects and advantages of the present invention: 1. By combining aerobic exercise (gradually increasing the walking distance after surgery) with specific-site exercises (ankle pump exercise, Kegel exercise), the present invention advances the first anal exhaust time by 12.3 hours, shortens the defecation time by 9.8 hours, reduces the incidence of intestinal obstruction by 67%, and at the same time increases the 6-minute walking distance by 25% in the exercise intervention group, significantly promoting gastrointestinal peristalsis and the recovery of body activity ability, and achieving an accelerated recovery effect on accelerating the recovery of gastrointestinal function and body function after colorectal cancer surgery; 2. By adopting pulmonary function training (cough training, respiratory trainer) combined with movements such as "Lifting the Heavens with Both Hands to Regulate the Triple Burner" in Baduanjin, the present invention increases the forced vital capacity of patients by 17.9%, increases the alveolar ventilation volume by 12%, restores the respiratory rate to normal, and reduces the incidence of pulmonary infection from 22% to 9%, effectively enhancing respiratory strength and reducing the risk of complications such as atelectasis. For the problems of weakened respiratory function and high risk of pulmonary infection after surgery, it can effectively strengthen respiratory function and prevent pulmonary complications; 3. By combining elastic band resistance training with traditional Chinese Baduanjin, the present invention increases the upper limb muscle strength by 25%, increases the back muscle strength by 30%, and increases the core muscle group endurance by 30%, significantly improving the shoulder joint mobility and reducing the risk of falls. At the same time, it indirectly promotes the recovery of intestinal function through the "muscle-gut axis" mechanism. For the problems of muscle atrophy and poor core stability after surgery, it can enhance muscle strength and body function and promote blood circulation.

[0018] 4. The compound exercise of the present invention increases the anti-inflammatory cytokines by 30% and reduces the cortisol level by 20% through regular exercise, and reduces the incidence of serious complications such as anastomotic leakage by 50%. Combining psychological intervention to improve patient compliance, it forms a double guarantee of "physiological regulation + psychological support", accelerating the overall rehabilitation process. For the problems of strong inflammatory response and high incidence of complications such as anastomotic leakage after surgery, it can regulate inflammatory stress and reduce the risk of postoperative complications. BRIEF DESCRIPTION OF THE DRAWINGS

[0019] Figure 1 It is a flowchart of the method for the compound exercise of the present invention to accelerate the postoperative rehabilitation training of colorectal cancer.

[0020] Figure 2 It is a flowchart of the overall exercise intervention measures of the present invention. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0021] Next, the technical solutions in the embodiments of the present invention will be clearly and completely described in conjunction with the accompanying drawings in the embodiments of the present invention. Obviously, the described embodiments are only a part of the embodiments of the present invention, rather than all the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those of ordinary skill in the art without creative efforts shall fall within the protection scope of the present invention.

[0022] Example 1: Patient Screening, Grouping and Control Measures Patients who underwent colorectal cancer surgery in a certain tertiary hospital and voluntarily participated in this rehabilitation training study were selected. The screening criteria were as follows: Pathologically diagnosed with colorectal cancer and successfully underwent surgery; Aged 18 - 75 years old, Karnofsky score ≥ 60 points (good physical status); Without severe organ function disorders such as heart, lung, liver, and kidney, and without contraindications to exercise.

[0023] 80 patients were divided into: Exercise intervention group (40 cases): The exercise intervention group was further evenly divided into four groups by random lottery, marked as groups A, B, C, and D respectively. Subsequently, the compound exercise accelerated rehabilitation training of the present invention will be implemented for these four groups; Routine nursing group (40 cases): Received routine postoperative nursing in the hospital; In summary, through patient screening, grouping and control measures, 80 patients were screened by strict inclusion criteria, randomly divided into an exercise intervention group and a routine nursing group, and the intervention group was further subdivided to ensure the homogeneity and comparability of the research objects, providing a scientific sample basis for verifying the effectiveness of the compound exercise on the accelerated rehabilitation program after colorectal cancer surgery.

[0024] Example 2: Development and Implementation of the Exercise Plan The first step of the combined exercise rehabilitation training for the exercise intervention group: During the training of the exercise intervention group, aerobic exercise is first adopted. On the day after surgery, after the patient wakes up from anesthesia for 6 hours, the nursing staff assists the patient to take a semi-recumbent position. At the same time, the patient is helped to turn over and pat the back every 2 hours, and the patient is assisted to cough and expectorate to prevent pulmonary complications. On the first day after surgery, the responsible nurse or family member assists the patient to change positions and encourages the patient to perform bedside activities. First, let the patient sit on the edge of the bed for 5 minutes. If there are no discomfort symptoms such as dizziness and palpitation, then assist the patient to stand for 1 - 3 minutes, and finally walk slowly. The activity time is 1 hour, the minimum walking distance reaches 1000 meters, and the number of steps is not less than 2000 steps. On the second day after surgery, the family member or professional caregiver assists the patient to move around in the ward and corridor. Before and after the activity, foods rich in protein and carbohydrates can be provided for the patient to help the patient supplement energy and promote muscle recovery. The activity time is controlled within 1 - 2 hours, the minimum walking distance is 1300 meters, and the number of steps is 2600 steps. On the third day after surgery: The patient's activity time is increased to 3 - 4 hours, the minimum walking distance is 1600 meters, and the number of steps is 3200 steps. One week after surgery: The patient's activity time is 5 - 6 hours, the minimum walking distance is 3000 meters, and the number of steps is 6000 steps, which promotes the recovery of gastrointestinal function, accelerates intestinal peristalsis, shortens the time of the first anal exhaust and the first defecation, reduces the incidence of intestinal obstruction, stimulates the mesenteric blood circulation through regular walking, and enhances the contractility of intestinal smooth muscle. Before and after each aerobic exercise, the patient is guided to perform 5 - minute warm-up and relaxation training. The warm-up activities include slow joint activities, stretching, etc. The relaxation training mainly includes deep breathing and relaxation of the whole body muscles, and the content of psychological intervention and support can be increased. During the exercise rehabilitation process, a professional psychologist is arranged to provide psychological counseling for the patient to help the patient establish a positive rehabilitation attitude and improve the compliance with exercise rehabilitation.

[0025] The second step of the combined exercise rehabilitation training for the exercise intervention group: Train specific parts. During the ankle pump exercise on the day after surgery, when the patient does not get out of bed, the nursing staff guides the patient to perform ankle pump exercise for 5 - 10 minutes according to the prepared standard video. The specific method is as follows: The patient lies flat on the bed, slowly hooks the feet, tries to make the toes face oneself, holds for 5 - 10 seconds when reaching the maximum limit, then slowly puts them down, and then slowly presses the feet down, holds for 5 - 10 seconds when reaching the maximum limit, and repeats this process to prevent deep vein thrombosis of the lower extremities, promote venous return of the lower extremities, improve limb circulation, increase the blood flow velocity of the lower extremity veins, reduce lower extremity edema, and promote the safety of early postoperative activities.

[0026] The third step of the combined exercise rehabilitation training for the exercise intervention group: Kegel exercises. For patients with tumors invading the bladder and undergoing bladder surgery, Kegel exercises are started 14 days after the surgery. First, guide the patients to find the pelvic floor muscles by suddenly holding back urine during urination. Then, the patients lie in bed, flatten their backs, place their arms on both sides of the body, bend their knees slightly and keep them together, and keep their heads flat. Contract the pelvic floor muscles for 5 seconds, then contract for another 5 seconds, and then relax for 10 seconds. Repeat the exercise 10 times as a set, and perform 3 - 4 sets every day. This can repair the pelvic floor muscles, increase the contraction force of the pelvic floor muscles by 25%, reduce the incidence of urinary incontinence from 20% in the control group to 8% in the intervention group, promote the recovery of bladder function, reduce the incidence of postoperative dysuria by 60%, and advance the time of the first spontaneous urination by 10 hours.

[0027] The fourth step of the combined exercise rehabilitation training for the exercise intervention group: Pulmonary function cough training. Guide the patients to take a sitting or semi - sitting position, with their feet on the ground and their heads tilted slightly forward. First, take a deep breath to fully inhale the gas into the lungs, then hold it for 1 - 2 seconds, and then use the strength of the chest and abdominal muscles to cough forcefully to promote the discharge of sputum. This can improve the forced vital capacity, and synchronously increase the tidal volume and the maximum ventilation volume, and enhance the contraction force of the diaphragm and intercostal muscles.

[0028] The fifth step of the combined exercise rehabilitation training for the exercise intervention group: Blowing balloons. Prepare balloons with a capacity of 500 ml and let the patients blow them forcefully. When the diameter of the blown balloon reaches 10 cm and is held for 5 seconds, it is considered as 1 effective exhalation. Each training session consists of 10 - 15 times, and it is performed 2 - 3 times a day. This can increase the alveolar ventilation volume by 12%, raise the blood oxygen saturation by 5% - 8%, and reduce the incidence of postoperative hypoxemia.

[0029] The sixth step of the combined exercise rehabilitation training for the exercise intervention group: Training with a respiratory trainer. Assist the patients to adopt a comfortable standing or sitting position, put the mouthpiece of the respiratory trainer into the mouth, and tightly hold it with the lips. The patients take a deep breath, blow the breathing ball to the preset scale and then hold their breath for 2 - 3 seconds, and then slowly exhale through pursed lips and remove the trainer. Each group consists of 20 - 30 times, and 1 - 2 groups are performed each time, and it is performed 2 - 3 times a day. Each training session lasts for 15 - 30 minutes. After using the respiratory trainer, the patients' respiratory rate returns from shallow and rapid (24 breaths / min) to normal (16 - 20 breaths / min), and the number of effective coughs increases.

[0030] The seventh step of the combined exercise rehabilitation training for the exercise intervention group: Resistance training. Select training elastic bands with appropriate resistance. Each training session includes the following 4 actions; Standing shoulder press action: The patient stands with feet shoulder-width apart, holds both ends of the elastic band with both hands, places the elastic band above the shoulders, then straightens the arms and pushes up the elastic band until the arms are straight, and slowly lowers them. Repeat this to improve the range of motion of the shoulder joint (forward flexion, abduction). The incidence of postoperative shoulder stiffness is reduced by 40%. It is especially suitable for patients with scapulocervical muscle adhesion caused by long-term bed rest. It enhances shoulder stability and improves the ability to perform daily movements such as dressing, combing hair, and lifting objects. Through the resistance push action, it stimulates the contraction of shoulder muscle groups, promotes blood circulation in the shoulders, and reduces muscle disuse atrophy caused by postoperative immobilization; Standing curl: Stand with feet, fix the elastic band under the feet, hold both ends of the elastic band with both hands, let the arms hang down, then slowly bend the arms, pull the elastic band towards the shoulders, and then slowly lower it. The flexor muscle strength of the elbow increases by 25%, significantly improving the ability to perform fine movements such as using tableware and wringing a towel, and reducing the risk of falling: The enhanced strength of the forearm flexors can improve hand stability, and combined with lower limb training, the balance ability score is increased by 18%. The resistance flexion action of the elastic band directly stimulates the contraction of the biceps brachii, activates satellite cells to promote muscle repair, and at the same time indirectly improves intestinal peristalsis through the "muscle-gut axis" mechanism.

[0031] Standing chest press: Stand with feet, pass the elastic band around the back, hold both ends of the elastic band with both hands, bend the arms in front of the chest, then forcefully straighten the arms and push forward, and then slowly retract. The thickness of the pectoral muscles increases by 15%, improving the hunchback posture, reducing the incidence of postoperative chronic back pain, enhancing the stability of the sternum, reducing the incision traction pain during coughing (the Changhai pain scale score decreases by 3 points during coughing), indirectly promoting effective expectoration. The contraction of the pectoralis major can assist in the expansion of the chest cavity. Combined with diaphragmatic breathing training, the maximum ventilation volume is increased by 12%. The horizontal push action activates the transverse fibers of the pectoralis major, increasing the anteroposterior diameter of the chest cavity. When used in combination with a respiratory trainer, it can form a "active breathing-muscle resistance" synergistic effect, directly enhancing alveolar ventilation.

[0032] Forceful pulling and lifting: Fix the elastic band on one side, the patient holds the elastic band with both hands and pulls forcefully towards one side of the body, then slowly relaxes. In the clinical mechanism, the strength of the back muscles increases by 30%, improving the "postoperative protective bending" posture, extending the maintenance time of the spinal neutral position by 50%, reducing the risk of lumbar compensatory strain, enhancing core stability, assisting in actions such as getting out of bed and turning around, reducing the occurrence of falls. The large-range stretching and contraction action of the back promotes the return of blood in the superior vena cava, reducing the incidence of jugular vein distension by 60%. Combined with ankle pump exercises, it can overall improve systemic blood circulation. The unilateral pulling and lifting action stimulates the longitudinal contraction of the latissimus dorsi, expanding the chest cavity volume, and indirectly enhancing the ventilation volume at the base of the lungs. It is especially suitable for preventing hypostatic pneumonia caused by long-term bed rest after surgery.

[0033] Each action is performed 10 - 12 times, with a 2 - minute rest interval between actions. Each training session lasts for 15 - 30 minutes and is carried out 2 - 3 times a day. For patients undergoing resistance exercise, the protein intake is appropriately increased to support muscle repair and growth. The four resistance band actions target and exercise the shoulder, arm, chest, and back muscle groups, not only directly improving upper limb function and core stability, but also assisting respiratory movement, promoting circulation through anatomical linkage effects, and regulating the muscle inflammation axis at the molecular level, forming a triple effect of "function recovery - complication prevention - psychological support". Clinical data shows that the muscle strength - related indicators of patients in the resistance training group were significantly better than those in the conventional group 1 week after surgery, and there was a significant positive correlation with the recovery of respiratory function and gastrointestinal function. It is an essential core component of the composite exercise program.

[0034] Traditional Chinese medicine exercise: Arrange for patients to perform traditional Chinese medicine exercises such as Bajiecao and Baduanjin every day, once in the morning and once in the afternoon, with each exercise session lasting for 15 - 20 minutes. Before performing traditional Chinese medicine exercises, professional rehabilitation therapists conduct action demonstrations and explanations to ensure that patients master the correct action essentials; Bajiecao takes the eight - xie acupoints on the hand (between the finger joints on the back of the hand) as the stimulation target. Through actions such as finger flexion and extension, wrist rotation, and palm - finger opening and closing, combined with breathing and mental regulation, it achieves "unblocking meridians and collaterals, regulating qi and blood, stimulating the endings of the three yin and three yang meridians of the hand, promoting blood circulation in the hand (the fingertip oxygen saturation increases by 10%), relieving finger numbness or stiffness caused by long - term intravenous infusion after surgery. The hand meridians are closely related to the motor area of the cerebral cortex. Regular actions can activate the prefrontal cortex, reduce sympathetic nerve activity, and relieve postoperative anxiety. The hand meridians are connected to the spleen and stomach meridians. The wrist rotation in the action can indirectly stimulate the celiac plexus, promote gastrointestinal peristalsis, and advance the time of the first anal exhaust; Baduanjin realizes the smooth flow of qi and blood throughout the body and the harmony of zang - fu functions through the integration of "adjusting the body (limb movement), adjusting the breath (breathing control), and adjusting the mind (concentration of the mind)", which is especially suitable for patients with qi and blood deficiency after surgery; "Lifting the hands up to support the sky and regulate the triple energizer" expands the thoracic cavity volume through spinal extension. Combining with deep inhalation can increase the tidal volume by 15%, assisting the respiratory trainer to improve the alveolar ventilation efficiency; "Regulating the spleen and stomach requires single - hand lifting" stretches the abdominal wall through lateral flexion on the left and right sides, enhances the movement amplitude of the diaphragm, and improves the efficiency of abdominal breathing; Actions such as "Shaking the head and wagging the tail to get rid of heart fire" and "Holding the feet with both hands to strengthen the kidneys and waist" strengthen the lumbar and dorsal muscles, abdominal muscles, and pelvic floor muscles, increasing the endurance of the core muscle group by 30% and reducing postoperative low back pain; Regular exercise reduces the activity of salivary amylase by 25% and the cortisol level by 20%. At the same time, anti - inflammatory cytokines increase by 30%, forming an "anti - inflammatory and immune enhancement" effect, and reducing the incidence of serious complications such as anastomotic leakage by 50%; Synergistically enhance muscle strength with elastic band resistance training (upper limb muscle strength increased by 25%), and cooperate with pulmonary function exercise to improve the breathing pattern (the coordination of thoracic + abdominal breathing increased by 30%), forming a composite effect of "local function strengthening + overall function regulation"; Through the core mechanisms of traditional Chinese medicine such as dredging meridians, regulating qi and blood, and calming the mind, Baduanxie and Baduanjin play the following key roles in the postoperative rehabilitation of colorectal cancer. Physiological level: improving respiratory function, enhancing core and limb functions, regulating inflammatory stress, and promoting gastrointestinal peristalsis; Psychological level: relieving anxiety and depression, improving sleep quality, and enhancing rehabilitation confidence; Synergistic level: Complementary to Western medicine exercise therapy, reducing the risk of complications and accelerating the recovery of daily living ability. Clinical data confirm that the addition of traditional Chinese medicine exercise makes the composite exercise program significantly better than pure Western medicine exercise in dimensions such as fatigue management, cardiopulmonary function, and psychological rehabilitation, reflecting the effect of integrated traditional Chinese and Western medicine rehabilitation.

[0035] 3. Conventional nursing group, the specific measures are as follows: Postoperative activity restrictions: On the first day after surgery: Strict bed rest, no getting out of bed allowed, only allowed to turn over once every 2 hours, passive movement of the limbs, no active movement guidance; On the second day after surgery: Can be adjusted from the supine position to the semi-recumbent position, cumulative bedside sitting ≤ 30 minutes, getting out of bed and standing time ≤ 10 minutes / time, no systematic walking training; On the third day after surgery and later: Cumulative getting out of bed activity time > 2 hours / day, the activity content is limited to slow pacing in the ward, no clear exercise intensity or step requirements; Rehabilitation training content: Do not perform any pulmonary function training, resistance exercise or traditional Chinese medicine exercise, only assist coughing by nurses (as needed), no active breathing training guidance; Other nursing: Routine monitoring of vital signs, wound care, intravenous fluid replacement and nutritional support, following the hospital's standard postoperative nursing process; In summary, through the combination of aerobic exercise (progressive walking after surgery), specific part exercises (ankle pumps, Kegel exercises), pulmonary function exercises (cough training, respiratory trainers), elastic band resistance training and traditional Chinese medicine exercises (Baduanxie, Baduanjin), the exercise program formulation and implementation can specifically improve the gastrointestinal function of patients (the first anal exhaust time in the intervention group was advanced by 12.3 hours), respiratory function (forced vital capacity increased by 17.9%), muscle strength (upper limb muscle strength increased by 25%) and systemic circulation (reducing the risk of deep vein thrombosis). At the same time, combined with psychological intervention to improve rehabilitation compliance, forming a comprehensive rehabilitation model of "physiological regulation + psychological support", which has a significant effect of accelerating the rehabilitation speed compared with the recovery measures of conventional nursing.

[0036] Example 3: Control of the timing and indications of exercise intervention Indications for starting exercise: When the patient is conscious, vital signs (body temperature, heart rate, blood pressure, respiration, etc.) are stable, muscle strength of the four limbs is greater than grade 3, the pain score evaluated by the Changhai Pain Scale is less than 4 points, and there is no bleeding or exudation from the surgical incision, exercise intervention can be started. First, assist the patient to sit on the edge of the bed for 5 minutes, observe whether the patient has discomfort symptoms such as dizziness and palpitation. If the patient has no special discomfort, after completing the sitting activities, then assist the patient to stand for 1 - 3 minutes. After confirming no orthostatic intolerance, gradually start exercise training.

[0037] Indications for stopping exercise: During exercise, if the pain score of the Changhai Pain Scale is greater than 4 points during the patient's rest, heart rate is greater than 100 beats per minute or less than 40 beats per minute, oxygen saturation is less than 90%, systolic blood pressure is less than 90 mmHg and / or diastolic blood pressure is less than 50 mmHg, there are situations such as fever, excessive wound bleeding or exudation, or orthostatic intolerance symptoms (such as dizziness, syncope, palpitation, etc.), weakness in activities, and the pain score of the Changhai Pain Scale is greater than 5 points when getting out of bed, exercise should be stopped immediately and the doctor should be notified in time for corresponding treatment; In summary, for the control of the timing and indications of exercise intervention, clarify the quantitative criteria for starting and stopping exercise, based on indicators such as vital signs, pain score, and muscle strength, ensure the safety and personalization of exercise, avoid complications caused by premature or excessive exercise, and ensure the scientific and orderly development of rehabilitation training.

[0038] Example 4: Evaluation of rehabilitation effect Evaluation of postoperative recovery indicators: Arrange a dedicated person to observe and record in detail the patient's first anal exhaust time, first defecation time, and first time getting out of bed Comparison table of postoperative recovery indicators Comparison table of respiratory function and exercise ability indicators Comparison table of postoperative complication incidence rates At the same time, use the method of questionnaire survey to evaluate the patient's cancer-related fatigue performance, monitor the patient's heart rate variability (HRV) through professional equipment, and compare the differences between the exercise intervention group and the conventional nursing group in these indicators.

[0039] Record of surgical complications: According to the Clavien-Dindo classification standard, record the types of complications at grade II and above in the patient, such as incision infection, abdominal bleeding, pleural effusion, gastrointestinal bleeding, intestinal obstruction, paralytic ileus, anastomotic stenosis, anastomotic fistula, pulmonary infection, urinary tract infection, renal failure, liver failure, and cardiovascular and cerebrovascular events (including thrombosis and embolism, incidence of deep vein thrombosis), etc., and count the occurrence and incidence of postoperative complications in the two groups of patients.

[0040] Assessment of motor ability and cardiopulmonary endurance: In accordance with the operation standards of the 6-minute walk test and the operation specifications of the "Chinese Expert Consensus on the Clinical Application of the 6-minute Walk Test in Elderly Patients", measure the 6-minute walking distance of the patients. Before the test, explain the test method and precautions to the patients in detail, and let the patients walk as fast as possible on a flat and quiet corridor for 6 minutes, and record the walking distance. Evaluate the cardiac function of the patients according to the results of the 6-minute walk test. At the same time, based on the modified Barthel index rating scale, score the activities of daily living of the patients from 10 items such as eating, dressing, going up and down stairs, and walking on flat ground, and compare the score differences between the two groups of patients.

[0041] Respiratory function measurement: Use a professional pulmonary function tester to measure the maximum ventilation volume, alveolar ventilation volume, respiratory rate, forced vital capacity, tidal volume, vital capacity and other indicators of the two groups of patients. Before the test, instruct the patients to keep quiet and emotionally stable, and avoid strenuous exercise and smoking. During the test, guide the patients to breathe according to the correct operation method to ensure the accuracy of the test results, record the measurement data and conduct comparative analysis.

[0042] Detection of stress hormones and inflammatory indicators: Draw blood from the two groups of patients at specific time points after the operation (such as the 1st day, 3rd day, 7th day after the operation, etc.) to detect indicators such as white blood cell count, C-reactive protein, procalcitonin, cortisol, interleukin 6, tumor necrosis factor α, etc. Use professional detection equipment and methods for detection, record the blood test data, and analyze the changes in stress hormones and inflammatory indicators in the two groups of patients; In summary, rehabilitation effect evaluation: Quantitatively evaluate from multiple dimensions such as postoperative recovery indicators (first exhaust / fecal discharge time), respiratory function (lung ventilation volume), motor ability (6-minute walking distance), complication incidence rate (59% reduction in pulmonary infection rate), and inflammatory stress indicators, providing objective data support for the effectiveness of the plan.

[0043] Example 5: Data processing and plan optimization Use statistical software such as SPSS, 9CHISS, and SAS to process the above-mentioned evaluation and monitoring data. For measurement data, if it conforms to a normal distribution, use a t-test for between-group comparison; if it does not conform to a normal distribution, use a non-parametric test. For count data, use a chi-square test for analysis, analyze the intervention effect of combined exercise on the postoperative rehabilitation, respiratory function, and inflammatory stress response levels of colorectal cancer patients, and optimize and adjust the rehabilitation training method according to the analysis results, such as adjusting the intensity, frequency, and combination method of exercise, etc., to improve the effect of rehabilitation training and provide a more scientific and effective rehabilitation plan for colorectal cancer patients.

[0044] In summary, data processing and solution optimization: Use statistical software to analyze the evaluation data. Through between-group comparison and correlation research, accurately optimize the exercise intensity, frequency, and combination method to achieve dynamic adjustment and iterative upgrade of the rehabilitation plan, and continuously improve the scientificity and effectiveness of postoperative rehabilitation for colorectal cancer.

[0045] Finally, the following points should be noted: First, in the description of this application, it should be noted that unless otherwise specified and defined, the terms "installation", "connection", and "linkage" should be understood in a broad sense. It can be a mechanical connection or an electrical connection, or it can be the communication inside two components. It can be directly connected. "Up", "down", "left", "right", etc. are only used to represent the relative position relationship. When the absolute position of the object being described changes, the relative position relationship may change; Second: In the attached drawings of the disclosed embodiments of the present invention, only the structures related to the disclosed embodiments of the present disclosure are involved. Other structures can refer to the usual designs. Without conflict, the same embodiment and different embodiments of the present invention can be combined with each other; Finally: The above are only the preferred embodiments of the present invention and are not used to limit the present invention. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principle of the present invention shall be included within the protection scope of the present invention.

Claims

1. A method for accelerating the rehabilitation training of complex exercise based on postoperative colorectal cancer, characterized in that, Including the following steps; S1. Patient screening and grouping: Select colorectal cancer patients who have undergone surgical treatment and are willing to participate, screen out patients meeting specific conditions, and randomly divide them into an exercise intervention group and a routine care group; further randomly divide the exercise intervention group into several small groups to carry out different combinations of complex exercises; S2. Exercise program formulation and implementation: 2.1 Aerobic exercise: According to the postoperative recovery stage of the patients, gradually increase the activity time and walking distance, and conduct warm-up and relaxation training before and after exercise; 2.2 Specific part exercise: Carry out exercise training for specific parts such as ankle pump exercise and Kegel exercise according to different surgical conditions; 2.3 Lung function exercise: Adopt methods such as cough training, blowing balloons, and using a respiratory trainer to carry out lung function exercise; 2.4 Resistance training: Use tools such as elastic bands to carry out resistance training, including various action combinations; 2.5 Traditional Chinese medicine exercise: Introduce traditional Chinese medicine exercise methods such as Bajie exercise and Baduanjin; S3. Control of exercise intervention timing and indications: Define the indications for starting and stopping exercise to ensure that exercise is carried out within the range allowed by the patient's physical condition; S4. Rehabilitation effect evaluation: Evaluate from multiple aspects such as postoperative recovery indicators, surgical complications, exercise ability and cardiopulmonary endurance, respiratory function, stress hormones and inflammatory indicators, and record relevant data; S5. Data processing and program optimization: Use statistical software to analyze the evaluation data, and optimize and adjust the rehabilitation training method according to the analysis results.

2. The method of compound exercise accelerated rehabilitation training based on post-operative colorectal cancer according to claim 1, characterized in that: In the patient screening and grouping step, 80 patients are screened out, with 40 patients in each of the exercise intervention group and the routine care group. The exercise intervention group is evenly divided into 4 groups.

3. A method for accelerating the rehabilitation training of compound exercise based on postoperative colorectal cancer, characterized in that: In the step of controlling the exercise intervention timing and indications, the indication for starting exercise is: clear consciousness, stable vital signs, limb muscle strength > 3 levels, Changhai pain scale pain score < 4 points, no bleeding or exudation at the incision, no discomfort after sitting on the edge of the bed for 5 minutes, completing sitting activities, and no orthostatic intolerance after standing for 1 - 3 minutes; The indication for stopping exercise is: Changhai pain scale pain score > 4 points during rest, heart rate > 100 beats / min or < 40 beats / min, blood oxygen saturation < 90%, systolic blood pressure < 90 mmHg and / or diastolic blood pressure < 50 mmHg, fever, excessive bleeding or exudation at the wound, and orthostatic intolerance symptoms, weakness in activities, and Changhai pain scale pain score > 5 points when getting out of bed and moving.

4. A method for accelerating the rehabilitation training of complex exercise based on post - colorectal cancer surgery according to claim 1, characterized in that: In the aerobic exercise step, assist the patient to take a semi-recumbent position and perform activities in bed 6 hours after anesthesia is awake on the day after surgery, and turn the patient over and pat the back every 2 hours; Assist the patient to get out of bed and move for 1 hour on the first day after surgery, with a minimum walking distance of 1000 meters and 2000 steps; Activity for 1 - 2 hours on the second day after surgery, with a minimum walking distance of 1300 meters and 2600 steps; Activity for 3 - 4 hours on the third day after surgery, with a minimum walking distance of 1600 meters and 3200 steps; Activity for 5 - 6 hours 1 week after surgery, with a minimum walking distance of 3000 meters and 6000 steps, and conduct 5-minute warm-up and relaxation training before and after exercise.

5. A method for accelerating the rehabilitation training of compound exercise based on post - colorectal cancer surgery according to claim 1, characterized in that: In the specific part exercise step, perform ankle pump exercise for 5 - 10 minutes when the patient does not get out of bed on the day after surgery; For patients with tumor invading the bladder and undergoing bladder surgery, Kegel exercises are carried out 14 days after the operation. Contract the muscles for 5 seconds, hold for 5 seconds, and relax for 10 seconds. Repeat 10 times as a set, and do 3 - 4 sets every day.

6. A method for accelerating postoperative rehabilitation training of colorectal cancer based on combined exercise, characterized in that: In the described pulmonary function exercise steps, it includes cough training, balloon blowing training, and using a respiratory trainer: During cough training, the patient takes a sitting or semi - sitting position, feet on the ground, head slightly forward, takes a deep breath and holds for 1 - 2 seconds, then coughs forcefully; During balloon blowing training, blowing a balloon with a capacity of 500 mL until the diameter reaches 10 cm and holding for 5 seconds is considered an effective exhalation; When using the respiratory trainer, take a comfortable standing or sitting position, blow until the preset scale, hold your breath for 2 - 3 seconds, exhale through pursed lips and remove the trainer. Each group has 20 - 30 times, 1 - 2 groups each time, 2 - 3 times a day, and each time lasts for 15 - 30 minutes.

7. A method for accelerating the rehabilitation training of combined exercise based on post-operative colorectal cancer, characterized in that: In the described resistance training steps, select a suitable elastic band. Each group includes four actions: standing shoulder press, standing curl, standing chest press, and forceful pull. Each action is done 10 - 12 times, with a 2 - minute rest interval between actions. Each time lasts for 15 - 30 minutes, and do 2 - 3 times a day.

8. A method for accelerating the rehabilitation training of complex exercise based on post - colorectal cancer surgery according to claim 1, characterized in that: In the described traditional Chinese medicine exercise steps, carry out traditional Chinese medicine exercises such as Ba Xie Cao and Ba Duan Jin, 2 times a day, and each time lasts for 15 - 20 minutes.

9. A method for accelerating the rehabilitation training of combined exercise based on postoperative colorectal cancer, characterized in that: In the described rehabilitation effect evaluation steps, the postoperative recovery index evaluation includes the time of first anal exhaust, the time of first defecation, the time of first getting out of bed, the manifestation of cancer - related fatigue, heart rate variability (HRV), etc. The surgical complications are recorded according to the Clavien - Dindo classification standard for complications of grade II and above. The evaluation of motor ability and cardiopulmonary endurance uses the six - minute walk test and the modified Barthel index rating scale. The respiratory function is measured using a pulmonary function tester to measure the maximum ventilation volume, alveolar ventilation volume, respiratory rate, forced vital capacity, tidal volume, and vital capacity. For the detection of stress hormones and inflammatory indicators, blood is drawn to detect indicators such as white blood cell count, C - reactive protein, procalcitonin, cortisol, interleukin - 6, and tumor necrosis factor - α.

10. A method for accelerating postoperative rehabilitation training of colorectal cancer based on compound exercise, characterized in that: In the described data processing and protocol optimization steps, statistical software such as SPSS, 9CHISS, and SAS is used to analyze the evaluation data.

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