Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial
The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventi...
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Published in | Journal of thoracic disease Vol. 9; no. 7; pp. 1919 - 1929 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
China
AME Publishing Company
01.07.2017
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Subjects | |
Online Access | Get full text |
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Summary: | The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventional inspiratory muscle training (IMT).
A three-armed randomized controlled trial comparing the two training modalities and routine care was conducted in surgical LC patients. Patient groups received one of three treatment regimens: (I) high-intensity pulmonary rehabilitation (PR) that combined IMT with conventional resistance training (CRT) (combined PR group); (II) conventional PR (single IMT group); or (III) routine preoperative preparation (control group). The primary endpoint was a change in the occurrence of post-operative pulmonary complications (PPCs) that occurred within 30 days after surgery, while secondary endpoints included changes in length of hospital stay, quality of life (QoL) scores, 6-min walk distance (6-MWD) and peak expiratory flow (PEF).
A total of 90 enrolled patients were randomized into three groups with a computer-based 1:1:1 ratio. The intention-to-treat analysis of the study revealed that, compared with the Control Group, the Combined PR Group had a significant increase in
6-MWD (by 32.67 m, P=0.002),
PEF (by 14.3 L/min, P=0.001),
global scores (by 3.7, P=0.035); and a reduced
average total hospital stay (by 3.2 d, P=0.001) and ∆postoperative stay (by 3.6 d, P=0.001). With regard to PPC rate, the Combined PR Group had a somewhat lower PPC severity (grade II-V) compared to the Control Group.
This hospital-based short-term program of PR combining high-intensity IMT with CRT was significantly superior to the conventional IMT program, indicating that this approach would be a feasible strategy for treating LC patients, especially those waiting operations with surgery-related risk factors. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Contributions: (I) Conception and design: J Huang, Y Lai; (II) Administrative support: G Che; (III) Provision of study materials or patients: J Su, M Yang; (IV) Collection and assembly of data: J Huang, Y Lai; (V) Data analysis and interpretation: X Zhou, S Li; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. These authors contributed to the work equally and should be regarded as co-first authors. |
ISSN: | 2072-1439 2077-6624 |
DOI: | 10.21037/jtd.2017.06.15 |