Pulmonary Rehabilitation in lung cancer

Abstract

Non-small-cell lung cancer (NSCLC) represents a very severe disease, being its incidence increasingly reported and, nowadays, successfully treatable only when surgery is deemed to be feasible. Furthermore, the disease and the clinical effects related to the complementary therapies (radio and/or chemotherapy) may strongly affect, frequently with dramatic clinical side effects, the patient’s ability to endure physical exercise. In such context, the PR(PR), which has already been proved to be useful and effective in other diseases such as COPD, could play a pivotal role. The aim of this review article is, therefore, to analyze the pertinent data recently reported in English literature in order to highlight the role of rehabilitation as complementary therapy in the management of patients with NSCLC. The evidence currently available suggests that, when surgery is indicated, PR is a safe and feasible option, both during pre-operative and post-operative timing.The safety and feasibility of rehabilitation are proven even in inoperable patients, although to date, little evidence has been reported on its role in the overall management of such complex diseases.

The Effect of Inspiratory Muscle Training in Patients With Lung Cancer After Surgery: A Systematic Review

“…Studies in this systematic review showed that the short-term effect of P-IMT on the 6MWT was unclear. Noticeably, 2 studies, which showed a benefit in the 6MWT,25,28 added aerobic exercise in the IG but not in the CG; therefore, aerobic exercise can be the reason for the improvement of the 6MWT 37–39. In addition, it was impossible to recommend when to start P-IMT due to different starting points in included studies.…”

“…With only 1 study, it was difficult to assess the effect of P-IMT on V o 2peak . Like the 6MWT, the improvement of V o 2peak may be induced by aerobic exercise applied in the IG but not in the CG 37–39. The same caution should be applied while interpreting the effect of mid-to-long-term P-IMT on physical capacity.…”

“…Noticeably, 2 studies, which showed a benefit in the 6MWT, 25,28 added aerobic exercise in the IG but not in the CG; therefore, aerobic exercise can be the reason for the improvement of the 6MWT. [37][38][39] In addition, it was impossible to recommend when to start P-IMT due to different starting points in included studies. The result of this review did not suggest any ideal setting of P-IMT for the improvement of the 6MWT.…”

“…Like the 6MWT, the improvement of Vo 2peak may be induced by aerobic exercise applied in the IG but not in the CG. [37][38][39] The same caution should be applied while interpreting the effect of mid-to-long-term P-IMT on physical capacity. More studies with longer follow-ups are needed to understand the specific role as well as the ideal characteristics of P-IMT on physical capacity.…”