Preoperative Rehabilitation in Lung Cancer Patients: Yoga Approach

Health benefits of yoga for cancer survivors: An updated systematic review and meta-analysis

Objective

To evaluate the effects of yoga on health-related outcomes [i.e., physical function, mental health, and overall quality of life (QOL)] of cancer survivors via a systematic review and meta-analysis of randomized controlled trials (RCTs) over the past 5 years across cancer types.

Methods

An updated systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RCTs published from January 1, 2018, to February 23, 2023, were searched in five English databases (PubMed, The Cochrane Library, ISI, PsycINFO, and CINAHL), three Chinese databases (Wan Fang, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database), and three English clinical trials registry platforms (International Clinical Trials Registry Platform, ClinicalTrials.gov, and EU Clinical Trials Register).

Results

A total of 34 RCTs were included in this updated review. Yoga benefited the physical function, mental health, and overall QOL of cancer survivors. The effect size of yoga for most physical and mental health-related outcomes was relatively small, but that for the QOL was generally large. The impact of yoga on the QOL of cancer survivors ranged from moderate to high.

Conclusions

Yoga has health benefits for cancer survivors and could therefore be used as an optional supportive intervention for cancer-related symptom management.

Clinical Indicators of Effects of Yoga Breathing Exercises on Patients With Lung Cancer After Surgical Resection: A Randomized Controlled Trial

BACKGROUND

Cancer itself and surgery pose a heavy burden on adults with lung cancer. Yoga breathing exercises have been proposed as a form of pulmonary rehabilitation exercises to improve these patients' perioperative outcomes.

OBJECTIVE

To investigate the impact of yoga breathing exercises based on a problem-solving model on dyspnea, exercise capacity, anxiety, depression, and postoperative indwelling time of thoracic drainage tube and compliance in adults with lung cancer undergoing surgery.

METHODS

One hundred eight lung cancer patients were randomly assigned to receive problem-solving model-based yoga breathing exercises, yoga breathing exercises, or usual care. Outcomes were collected at admission, the day before surgery, and at discharge.

RESULTS

Patients in the combined intervention group showed a significantly greater improvement in dyspnea, exercise capacity, and anxiety compared with the control group. Yoga breathing training can significantly improve patients' dyspnea and anxiety. Significant difference favoring the combined group was observed in exercise capability and compliance between the 2 intervention groups. However, there was no significant difference in depression or indwelling time of thoracic drainage tube among the 3 groups at any time point.

CONCLUSION

Findings indicate that yoga breathing exercises are effective in alleviating perioperative symptoms of lung resection patients. Compared with yoga breathing exercises, applying additional problem-solving model may achieve a better effect.

IMPLICATIONS FOR PRACTICE

Yoga breathing exercises can be considered as a promising pulmonary rehabilitation strategy for lung cancer patients with surgery. The problem-solving model could be integrated into yoga breathing exercises in clinical practice to enhance the rehabilitation effect.

Malignant neoplasm of the bronchi and lung: Russian clinical guidelines

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Effects of ADOPT-Based Breathing Training Combined with Continuous Nursing on Quality of Life, Mental Health, and Self-Efficacy in Lung Cancer Patients Undergoing Chemotherapy: Based on a Retrospective Cohort Study

Objective

Considering the poor effect of routine nursing program on patients with lung cancer after chemotherapy, a retrospective cohort study was conducted to elucidate the effects of respiratory training based on ADOPT mode combined with continuous nursing on quality of life, mental health, and self-efficacy in patients undergoing lung cancer chemotherapy.

Methods

Sixty patients with lung cancer admitted in our hospital from January 2019 to April 2021 were selected. Patients in both groups received ADOPT breathing training. Patients who underwent routine nursing were assigned into control group (n = 30) and patients with continuous nursing were set as study group (n = 30). The differences in nursing satisfaction, self-management efficacy, quality of life score, mental health, family care index, and self-transcendence scale scores of patients with lung cancer were determined.

Results

First of all, we compared the baseline data of the two groups, and there was no statistical difference. In the comparison of nursing satisfaction between the two groups, 24 cases in the study group were very satisfied, 5 cases were satisfied, 1 case was general, and the satisfaction rate was 100%, whereas in the control, 14 cases were very satisfied, 8 cases were satisfied, 4 cases were not satisfied, and the satisfaction rate was 86.67%. Compared to the control, the nursing satisfaction was higher in the study group (P < 0.05). There exhibited no significant difference in the sense of self-management efficacy between the two on the day of admission (P > 0.05). After nursing, the scores of self-management efficacy were higher in the study group, compared to the control (P < 0.05). In contrast to control, the scores of self-management efficacy at discharge and 1, 3, and 6 months after discharge were higher in the study group (P < 0.05). In terms of the scores of quality of life of patients with lung cancer, on the day of admission, no significant difference exited (P > 0.05). The scores of quality of life at discharge and 1, 3, and 6 months after discharge of the study group were higher compared to the control (P < 0.05). In the comparison of mental health, there was no significant difference between the two groups on the day of admission (P > 0.05), but the scores of anxiety and depression in the two groups decreased after nursing, and the scores of anxiety and depression in the study group at discharge and 1 month, 3 months, and 6 months after discharge were lower than those in the control group (P < 0.05). In terms of the family care index, there was no significant difference between the two groups at admission (P > 0.05), but after nursing, the family care index of the two groups increased, and the family care index at discharge and 1, 3, and 6 months after discharge was greater in the study group (P < 0.05). In terms of the score of self-transcendence scale, there exhibited no significant difference on the day of admission (P > 0.05), but the score of self-transcendence scale of the two groups increased after nursing. Furthermore, compared to the control, the score of self-transcendence scale at discharge and 1 month, 3 months, and 6 months after discharge in the study group was higher (P < 0.05).

Conclusion

Patients undergoing lung cancer chemotherapy using ADOPT-based breathing training combined with continuous nursing can effectively facilitate the overall quality of life of lung cancer chemotherapy patients, promote the mental health and self-efficacy of patients with lung cancer chemotherapy, and then reduce the medical burden of patients. The nursing model based on ADOPT breathing training combined with continuous nursing is worthy to be applied in the rehabilitation of patients with lung cancer.

Prehabilitation exercise therapy for cancer: A systematic review and meta-analysis

OBJECTIVE

The purpose of this study was to determine the impact of prehabilitation exercise intervention with respect to (1) acceptability, feasibility, and safety; and (2) physical function, measured by 6-minute-walk test (6MWT).

DATA SOURCES

PRISMA guidelines were used to systematically search PubMed, Embase, and CINAHL databases evaluating prehabilitation exercise interventions.

STUDY SELECTION

The inclusion criteria were studies investigating patients who underwent surgery for their cancer and underwent prehabilitation exercise.

DATA EXTRACTION AND SYNTHESIS

Guidelines were applied by independent extraction by multiple observers. Data were pooled using a random-effects model.

MAIN OUTCOME(S) AND MEASURE(S)

Acceptability, feasibility, and safety rates were calculated. 6MWT (maximum distance a person can walk at their own pace on a hard, flat surface, measured in meters, with longer distance indicative of better performance status) was compared using two arms using the DerSimonian and Laird method.

RESULTS

Objective 1. Across 21 studies included in this review, 1564 patients were enrolled, 1371 (87.7%) accepted the trial; of 1371, 1230 (89.7% feasibility) completed the intervention. There was no grade 3+ toxicities. Objective 2. Meta-analysis of five studies demonstrated a statistically significant decrease in 6MWT distance postoperatively in the control group (mean difference = +27.9 m; 95% confidence interval (CI): 9.3; 46.6) and a significant improvement postoperatively in the prehabilitation group (mean difference = -24.1 m; 95% CI: -45.7; -2.6). Meta-analysis demonstrated improvements in 6MWT distance 4-8 weeks postoperatively in the prehabilitation group compared to the control group (mean difference = -58.0 m, 95% CI: -92.8; -23.3).

CONCLUSIONS AND RELEVANCE

Prehabilitation exercise for cancer patients undergoing surgery was found to be safe, acceptable, and feasible with a statistically significant improvement in the 6MWT, indicating that prehabilitation can improve postoperative functional capacity.

A Prospective Outcomes Pilot Evaluation of Inspire Now: A Program for People with Lung Cancer

Background:

Lung cancer is the leading cause of cancer mortality in Canada, yet patients are often under-supported. A six-week program called Inspire Now, created to address unmet supportive care needs, was evaluated in this study. Feasibility and preliminary outcomes were assessed in order to inform future changes to the program.

Objectives:

(1) Assess the feasibility of the program and its evaluation; (2) pilot the collection of patient-reported outcomes; (3) identify outcomes that may be positively influenced; and (4) inform program modifications.

Methods:

Participants were recruited from the first session of Inspire Now for an observational pilot study. The primary outcome was feasibility. Secondary outcomes included within-person changes in Functional Assessment of Cancer Therapy – Lung (FACT-L) and Measure Yourself Concerns and Wellbeing (MYCaW), and program satisfaction and qualitative experiences of participants and facilitators through internally-developed questionnaires and semi-structured interviews. Analysis was primarily descriptive, within person changes in FACT-L and MYCaW were analyzed using the Wilcoxon signed-rank test and qualitative data was assessed for common themes.

Results:

The program and its evaluation were feasible; 8 of 9 (89%) participants consented to the study, median attendance was 6 of 6 sessions (IQR 4.5-6), and questionnaire completion was 100% at baseline and 75% at follow-up. There were clinically meaningful improvements in MYCaW concern 1 (−1.2, 95% CI −2.0 to −0.4) and overall wellbeing (−0.9, 95% CI −2.1 to 0.4). Seven of eight FACT-L sub-sections trended toward improvement, with absolute changes ranging from −1.7 to 10.8%. Participant feedback was overwhelmingly positive; group support and social interactions were highly valued.

Conclusions:

The group intervention for people with lung cancer was feasible to both run and evaluate. Participants responded positively to the program. Findings will inform changes to future sessions and an analysis of multiple sessions is planned.

Prehabilitative Exercise for the Enhancement of Physical, Psychosocial, and Biological Outcomes Among Patients Diagnosed with Cancer

PURPOSE OF REVIEW

This review summarizes the effects of prehabilitative exercise interventions on the physical, psychosocial, and biological outcomes among patients with cancer. Current gaps and future directions in prehabilitative exercise research will be addressed.

RECENT FINDINGS

Prehabilitative exercise mitigates the detrimental impact of cancer surgery on physical fitness, noted by increases in maximal oxygen consumption and 6-min walk distance. Beneficial effects on psychosocial and biological outcomes remain inconclusive. Aerobic exercise interventions were often prescribed and included low-, moderate-, or high-intensity exercise. Resistance exercise interventions were often performed in conjunction with aerobic exercise. Prehabilitative exercise elicits robust improvements in physical fitness; however, effect on psychosocial and biological outcomes remains inconclusive. Exercise prescription parameters varied greatly by frequency, intensity, time, and type across multiple cancer diagnoses. Future investigations are needed to systematically dose exercise for a wider variety of outcome measures, with an overall goal to set forth pre-operative exercise guidelines.