Perioperative exercise intervention in patients with lung cancer

Abstract

Objectives: During perioperative, lung cancer (LC) patients are often left to experience debilitating disease-related symptoms, impaired physical activity and health-related quality of life (HRQoL), and social difficulties, despite the progress achieved in terms of treatment efficacy. Nonpharmacological intervention, such as exercise, has been identified as an effective strategy in LC patients before and after lung resection. Therefore, we aimed to assess evidence of the effect of perioperative exercise among patients with LC. Materials and Methods: Seven databases were searched from January 1998 to September 2020. All randomized controlled trials (RCTs) that evaluated the effect of exercise on the physical and psychological status of patients with LC during the perioperative period were reviewed. Two reviewers independently assessed the quality of all studies included here using the revised Cochrane risk of bias tool for RCTs. Results: Seventeen RCTs (1199 participants) published between 2011 and 2019 met for this literature review. The outcome measures that emerged from these studies included subjective outcomes, such as HRQoL, pain score, fatigue, and objective effects, such as cardiorespiratory fitness, pulmonary function, physical activity, and biological markers. Overall, these studies suggest that exercise should be an optimal option for LC; however, its efficacy and effectiveness regarding HRQoL should be investigated further. Conclusion: Perioperative exercise could be included in the rehabilitation program of patients with LC. More extensive, high-quality RCTs evidence is needed on the ideal exercise type, duration, intensity, and timing across the LC perioperative care.

Cáncer de pulmón de células no pequeñas y Entrenamiento físico preoperatorio

“…Aspectos psicosociales y funciones cardiorrespiratorias fueron evaluadas en la RS [9] donde la intervención incorporaba ejercicio aeróbico con entrenamiento muscular inspiratorio.…”

“…Se encontraron ocho revisiones sistemáticas [2,7-13], que incluyen en total 300 estudios primarios. El resumen se basa en las siguientes RS [2,[7][8][9][10][11], de acuerdo al resultado de la evaluación AMSTAR 2. Luego del proceso de evaluación con la herramienta AMSTAR 2 se determino que tres RS [7,8,9] resultaron con evaluación de alta confianza y fueron seleccionadas para el trabajo.…”

“…Lo que se diferencia de los principales resultados obtenidos por los estudios previamente descritos, donde las áreas que más se repitieron fueron: Complicaciones postoperatorias, Días de Postoperatorio, Calidad de vida, Dolor, Función Pulmonar, Capacidad de Ejercicio, Depresión, entre otras. [2,7,8,9,10,11] La mayoría de los estudios consideraba el test de rendimiento en la marcha de 6 minutos [2,7,8,9,10] como variable de resultado. Considerando la capacidad de ejercicio, como una medida útil para identificar a los pacientes con necesidad de optimización preoperatoria, encontrando en todas las revisiones una mejoría en el transcurso preoperatorio al utilizar esta técnica [8].…”