Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial

• Published in: Physiotherapy Vol. 100; no. 2; pp. 100 - 107
• Main Authors: Arbane, G, Douiri, A, Hart, N, Hopkinson, N.S, Singh, S, Speed, C, Valladares, B, Garrod, R
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2014
• Subjects: Aged; Carcinoma, Non-Small-Cell Lung - rehabilitation; Carcinoma, Non-Small-Cell Lung - surgery; Exercise; Exercise Therapy - methods; Exercise Tolerance; Female; Hospitals; Hospitals, Teaching; Humans; Lung cancer; Lung Neoplasms - rehabilitation; Lung Neoplasms - surgery; Male; Middle Aged; Muscle Strength; Non-small cell lung cancer; Physical activity; Physical Medicine and Rehabilitation; Quality of Life; Recovered; Surgery; Thoracotomy; Exercise; Thoracotomy; Surgery; Non-small cell lung cancer
• ISSN: 0031-9406; 1873-1465
• DOI: 10.1016/j.physio.2013.12.002

Abstract Objective To evaluate the effect of a combined hospital plus home exercise programme following curative surgery for non-small cell lung cancer (NSCLC). Design Randomised controlled trial. Setting Teaching hospital. Participants One hundred and thirty-one subjects with NSCLC admitted for curative surgery. Interventions Participants were randomised to usual care or a hospital plus home exercise programme. Outcomes The primary outcome was the between-group difference in physical activity 4 weeks after surgery. Secondary outcomes were the difference in quadriceps strength, exercise tolerance and quality of life [Short Form-36 (SF-36) and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-LC13] from pre-operatively (baseline) to 4 weeks after surgery. Results The participants ( n = 131) had a mean age of 68 [standard deviation (SD) 11] years and mean forced expiratory volume in 1 second of 2.4 (SD 1.1) l. There were no significant differences in physical activity between the groups 4 weeks after surgery [mean difference adjusted for baseline 12 minutes/day, 95% confidence interval (CI) −20.2 to 44.1]. In addition, there were no significant differences in total SF-36 or EORTC QLQ-LC13 scores from baseline to 4 weeks after surgery. Both groups had recovered their pre-operative walking distance 4 weeks after surgery, and there were no differences between the groups (mean difference in Incremental Shuttle Walk Test from baseline to 4 weeks after surgery (−26 m, 95% CI −94.2 to 42.3). Conclusions A hospital plus home exercise programme showed little benefit in unselected patients with NSCLC following surgery. Regardless of group allocation, the patients had recovered their pre-operative exercise tolerance levels by 4 weeks after surgery.