Early initiated postoperative rehabilitation reduces fatigue in patients with operable lung cancer: A randomized trial

Quist, Morten; Sommer, Maja Schick; Vibe-Petersen, Jette; Stærkind, Maja Bohlbro; Langer, Seppo W.; Larsen, Klaus; Trier, Karen; Christensen, Merete; Clementsen, Paul Frost; Missel, Malene; Henriksen, Carsten; Christensen, Karl Bang; Lillelund, Christian; Langberg, Henning; Pedersen, Jesper Holst

doi:10.1016/j.lungcan.2018.10.025

Cited by 42 publications

(58 citation statements)

References 37 publications

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“…Poor enrollment in clinical trials has been and still is an important issue in rehabilitation studies. The enrollment rate of 53% reported in the PROLUCA study (Quist et al, 2018) is quite similar to previous exercise oncology trials on patients after treatment for lung cancer (Arbane et al, 2011; Granger et al, 2011; Jones et al, 2011; Missel, Pedersen, Hendriksen, Tewes, & Adamsen, 2015). Careful analyses of perceptions, considerations, and attitudes of nonparticipation in rehabilitation are necessary to make significant progress in supporting people after lung cancer surgery.…”

Section: Discussionsupporting

confidence: 76%

“…Exercise training has also been associated with improved muscle strength, a reduction in postoperative complications, and shorter hospitalization (Arbane, Tropman, Jackson, & Garrod, 2011; Kenny et al, 2008). Against this background, an RCT was developed to investigate the efficacy of a postoperative exercise intervention for patients after lung cancer surgery (initiated as early as 2 weeks after surgery; Quist et al, 2018). This 12-week exercise intervention involved 24 group sessions and took place in a community-based training center.…”

Section: Introductionmentioning

confidence: 99%

“…Due to the feasibility study's promising results, considerable efforts were made to enlist participants for the RCT. Despite these efforts, only 53% of eligible participants consented to participate in the exercise intervention (Quist et al, 2018). A study by Bade, Thomas, Scott, and Silvestri (2015) indicated that possible barriers for participating in exercise interventions are high symptom burden, the side effects of treatments, and high prevalence of comorbidity.…”

Section: Introductionmentioning

confidence: 99%

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The Lived Experiences, Perceptions, and Considerations of Patients After Operable Lung Cancer Concerning Nonparticipation in a Randomized Clinical Rehabilitation Trial

Schoenau

Hansen²,

Ulvestad

et al. 2019

Qual Health Res

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The purpose of this study was to explore the lived experiences, perceptions, and considerations of individuals who declined participation in a randomized clinical trial involving exercise rehabilitation after surgery for lung cancer. An interpretive phenomenological approach was applied comprising interviews with 15 individuals who did not wish to participate in the trial. The findings shed light on a discrepancy between their freedom to act and make decisions and the limitations of having to act in a certain way. The participants found themselves in a gray area between a healthy life and a good life, as influenced by societal norms and taking responsibility for one’s own health and rehabilitation. When including patients in rehabilitation after lung cancer, having insight into the underlying narrative on values and the good life, priorities in daily life, social context and the norms embedded in people’s self-understanding is crucial.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Lived Experiences, Perceptions, and Considerations of Patients After Operable Lung Cancer Concerning Nonparticipation in a Randomized Clinical Rehabilitation Trial

Schoenau

Hansen²,

Ulvestad

et al. 2019

Qual Health Res

Self Cite

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“…After 12 weeks, fatigue, QoL, and cardiorespiratory fitness were significantly improved from the baseline assessment . Similarly, other interventional studies showed that EX ameliorates fatigue‐related symptoms , especially if initiated early after surgery . For instance, a randomized controlled trial including 96 patients with lung cancer (including NSCLC stage I–IV and SCLC) undergoing chemotherapy compared the effect of a tai chi program (performed every other day) versus low impact exercise (as a control group) on cancer‐related fatigue.…”

Section: Investigated Outcomes In Lung Cancermentioning

confidence: 90%

Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?

Avancini

Sartori

Gkountakos³

et al. 2019

The Oncologist

102

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Lung cancer remains the leading cause of cancer‐related death worldwide. Affected patients frequently experience debilitating disease‐related symptoms, including dyspnea, cough, fatigue, anxiety, depression, insomnia, and pain, despite the progresses achieved in term of treatment efficacy. Physical activity and exercise are nonpharmacological interventions that have been shown to improve fatigue, quality of life, cardiorespiratory fitness, pulmonary function, muscle mass and strength, and psychological status in patients with lung cancer. Moreover, physical fitness levels, especially cardiorespiratory endurance and muscular strength, are demonstrated to be independent predictors of survival. Nevertheless, patients with lung cancer frequently present insufficient levels of physical activity and exercise, and these may contribute to quality of life impairment, reduction in functional capacity with skeletal muscle atrophy or weakness, and worsening of symptoms, particularly dyspnea. The molecular bases underlying the potential impact of exercise on the fitness and treatment outcome of patients with lung cancer are still elusive. Counteracting specific cancer cells’ acquired capabilities (hallmarks of cancer), together with preventing treatment‐induced adverse events, represent main candidate mechanisms. To date, the potential impact of physical activity and exercise in lung cancer remains to be fully appreciated, and no specific exercise guidelines for patients with lung cancer are available. In this article, we perform an in‐depth review of the evidence supporting physical activity and exercise in lung cancer and suggest that integrating this kind of intervention within the framework of a global, multidimensional approach, taking into account also nutritional and psychological aspects, might be the most effective strategy. Implications for Practice Although growing evidence supports the safety and efficacy of exercise in lung cancer, both after surgery and during and after medical treatments, most patients are insufficiently active or sedentary. Engaging in exercise programs is particularly arduous for patients with lung cancer, mainly because of a series of physical and psychosocial disease‐related barriers (including the smoking stigma). A continuous collaboration among oncologists and cancer exercise specialists is urgently needed in order to develop tailored programs based on patients’ needs, preferences, and physical and psychological status. In this regard, benefit of exercise appears to be potentially enhanced when administered as a multidimensional, comprehensive approach to patients’ well‐being.

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“…42 Exercise commenced earlier rather than later postoperatively is associated with greater reductions in cancer-related fatigue. 43 A home-based physical activity intervention reported safety and feasibility during the postoperative period, with pre-operative physical activity levels maintained at eight weeks postoperatively. 44…”

Section: Perioperatively and Postoperativelymentioning

confidence: 96%