Effects of Presurgical Exercise Training on Quality of Life in Patients Undergoing Lung Resection for Suspected Malignancy

Abstract

The aim of this study was to explore the effects of presurgical exercise training on quality of life (QOL) in patients with malignant lung lesions. Using a single-group prospective design, patients were enrolled in supervised aerobic exercise training for the duration of surgical wait time (mean 59.7 days). Participants completed assessments of cardiorespiratory fitness (peak oxygen consumption) and QOL using the Functional Assessment of Cancer Therapy-Lung scales, including the trial outcome index (TOI) and the lung cancer subscale (LCS) at baseline, immediately presurgery, and postsurgery (mean, 57 days). 9 participants provided complete data. Repeated-measures analysis indicated a significant effect for time on TOI (P = .006) and LCS (P = .009). Paired analysis revealed that QOL was unchanged after exercise training (ie, baseline to presurgery), but there were significant and clinically meaningful declines from presurgery to postsurgery in the LCS (-3.6, P = .021) and TOI (-8.3, P = .018). Change in peak oxygen consumption from presurgery to postsurgery was significantly associated with change in the LCS (r = 0.70, P = .036) and TOI (r = 0.70, P = .035). Exercise training did not improve QOL from baseline to presurgery. Significant declines in QOL after surgery seem to be related to declines in cardiorespiratory fitness. A randomized controlled trial is needed to further investigate these relationships.

Pulmonary Rehabilitation in Patients with Lung Cancer

“…Fizyoterapi rehabilitasyon yaklaşımlarını araştıran çalışmalar, erken rehabilitasyon ve ameliyat sonrası komplikasyonları önlemeye yönelik koruyucu fizyoterapi rehabilitasyon tekniklerini içeren çalışmalardır (22). Diğerleri ise cerrahi girişime uygun olan hastalarda ameliyat öncesi (23)(24)(25)(26)(27), ya da sonrası dönemde egzersiz eğitiminin ön planda olduğu araştırmalardır (14,(28)(29)(30)(31). Birkaçında ileri evre akciğer kanserinde hastane içi PR uygulamaları da yapılmıştır (32)(33)(34).…”

“…Bu araştırmaların hiçbirinde kontrol grubu yoktur (14,(23)(24)(25)(26)(27)(28)(29)(30)(31). Hasta sayıları azdır (24,25,27,28,(30)(31)(32)34). Hepsinin birleştiği ortak nokta, hastaların egzersiz kapasitelerinin artmasıdır.…”

“…Hepsinin birleştiği ortak nokta, hastaların egzersiz kapasitelerinin artmasıdır. Cerrahi öncesi egzersiz eği-timi ile hastaların fiziksel fonksiyonlarının, kas kuvvet ve enduransının, 6 dakika yürüme testi mesafesinin ve sandalyeye otur kalk sayılarının, solunum kas kuvvetinin arttığı bulunmuştur (30). Araştırmacılar 8 haftalık hastane içi rehabilitasyon programıyla akciğer kanserli hastaların egzersiz kapasitelerinin artması nedeniyle, bu hastaların PR programları için iyi birer aday oldukları sonucuna varmışlardır (28).…”

Pulmonary Rehabilitation in lung cancer

“…Some studies have demonstrated that a training aerobic program is capable of significantly inproving not only oxygen consumption but also performance during the walking-test and overall QoL [77,78]; similarly Bobbio et al have investigated the oxygen consumption effects during a fourweek rehabilitation program carried out on a group of 12 COPD patient with NSCLC candidates for lobectomy. The program included a total of 20 sessions, diaphragmatic breathing exercises and a combined aerobic and strength training.…”

The key questions in rehabilitation in thoracic surgery

“…amegroups.com/public/system/jtd/jtd.2018.03.147-1. pdf) (24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). summarises the key findings, in brief, studies reported a statistically significant improvement in peak oxygen consumption (VO2max) or in functional capacity measured with the 6-minute walk test from baseline to postintervention.…”