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Sharma VS, Yadav V. Effect of Prehabilitation in Lung Cancer Patients Undergoing Lobectomy: A Review. Cureus 2023; 15:e49940. [PMID: 38179388 PMCID: PMC10765220 DOI: 10.7759/cureus.49940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Deaths from lung cancer are mostly caused by smoking. Cough, dyspnea, fatigue, weight loss, and Horner's syndrome are among the symptoms. Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) are the two categories into which lung cancer may be divided. Because of its effectiveness and lower death rates, lobectomy is the primary line of therapy for benign and early-stage lung illnesses. Pulmonary rehabilitation is a routine treatment for thoracic surgery individuals who are at a high risk to improve functional ability, avoid postoperative deterioration, avoid postoperative deterioration, and reduce complications and even hospital stays. Pulmonary rehabilitation is a multifaceted continuum of services intended to help individuals with pulmonary disease and their families reach and sustain their highest possible degree of independence and community functioning, typically provided by an interdisciplinary team of specialists. The objective of this research was to gather preliminary information and assess the effects of pre-rehabilitation on those suffering from lung cancer and having lobectomy. The pre-rehabilitation program's outcomes include increased lung functional capacity, enhanced quality of life, patient independence in daily living activities, and a shorter hospital stay. Gradually increasing walking distance over time can build endurance, requiring consistency, pacing, proper hydration, nutrition, and regular breaks. This review analyzed the effect of pre-rehabilitation in lung cancer patients undergoing lobectomy. Pre-rehabilitation program for individuals with lung cancer improves both preoperative and postoperative health through various exercises. Pulmonary rehabilitation is a multidisciplinary approach that encourages physical activity, learning about disease, treatment options, and coping mechanisms. Instead of curing the illness, its goal is to lessen its symptoms and limitations. Patients with pulmonary diseases or undergoing thoracic surgery prefer pre-rehabilitation programs due to their non-traumatic nature and fewer resources required. Elastic resistance band exercises are beneficial for lung cancer patients' pre-rehabilitation by strengthening and stretching muscle groups, improving exercise capacity, and supporting white blood cell counts. These exercises can be customized to individual needs, making them a safe and effective addition to a patient's exercise routine. They have to be carried out at least three days a week. Pulmonary exercise, including the use of a tri-ball pulmonary exerciser or three-ball spirometer, can improve lung function, respiratory muscle strength, and exercise capacity in lung cancer patients. It involves breathing techniques, cough exercises, and inflating a balloon. Pulmonary rehabilitation has a positive impact on patient health. Improved lung vital capacity, shorter hospital stays, and fewer problems following surgery are all achieved with pulmonary rehabilitation. The pre-rehabilitation plan allows the patient to resume their daily routines.
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Affiliation(s)
- Vaishnavi S Sharma
- Department of Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research (DU), Wardha, Maharashtra, IND
| | - Vaishnavi Yadav
- Department of Cardiorespiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education & Research (DU), Wardha, Maharashtra, IND
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Le Guen M, Falque L, Pison C. [Preparation for lung transplantation]. Rev Mal Respir 2023; 40 Suppl 1:e4-e12. [PMID: 36710209 DOI: 10.1016/j.rmr.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- M Le Guen
- Département d'anesthésie, Hôpital Foch, Suresnes, France; INRA UMR 892 VIM, équipe Vaccins Immunopathologie Immunomodulation, Jouy-en-Josas, France; Université Versailles Saint-Quentin, Versailles, France
| | - L Falque
- Service hospitalier universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France
| | - C Pison
- Service hospitalier universitaire Pneumologie Physiologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Grenoble, France; Inserm1055, Laboratoire de Bioénergétique Fondamentale et Appliquée, Grenoble, France; Université Grenoble Alpes, Grenoble, France.
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Andrianopoulos V, Gloeckl R, Boensch M, Hoster K, Schneeberger T, Jarosch I, Koczulla RA, Kenn K. Improvements in functional and cognitive status following short-term pulmonary rehabilitation in COPD lung transplant recipients: a pilot study. ERJ Open Res 2019; 5:00060-2019. [PMID: 31544112 PMCID: PMC6745414 DOI: 10.1183/23120541.00060-2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/20/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Pulmonary rehabilitation (PR) following lung transplantation (LTx) is considered part of the optimal treatment in chronic obstructive pulmonary disease (COPD) for favourable post-operative outcomes. We investigated the effects of a PR intervention in the post-transplant phase with regard to lung function, exercise responses and cognitive function in COPD LTx recipients. METHODS 24 COPD LTx recipients (mean±sd forced expiratory volume in 1 s 75±22% predicted) were assigned to a comprehensive 3-week inpatient PR programme. Changes from PR admission to discharge in lung function variables, 6-min walk test-derived outcomes and cognitive function were assessed and examined for several factors. The magnitude of changes was interpreted by effect size (ES). RESULTS In response to the PR intervention, LTx recipients had improved lung function with regard to diffusing capacity of the lung for carbon monoxide (+4.3%; p=0.012) and static hyperinflation (residual volume/total lung capacity -2.3%; p=0.017), increased exercise capacity (6-min walk test +86 m; p<0.001), and had small to large improvements (ES range 0.23-1.00; all p≤0.34) in 50% of the administered cognitive tests. Learning skills and memory ability presented the greatest benefits (ES composite scores 0.62 and 0.31, respectively), which remained similar after stratification by single or bilateral LTx and sex. CONCLUSIONS PR is an effective treatment for LTx recipients in the post-transplant phase, improving lung function, exercise responses, and domains of cognitive function of learning, memory and psychomotor speed. PR may facilitate the course of post-operative treatment and should be recommended in LTx.
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Affiliation(s)
- Vasileios Andrianopoulos
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Rainer Gloeckl
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Prevention, Rehabilitation and Sport Medicine, Technical University Munich, Munich, Germany
| | - Martina Boensch
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Katharina Hoster
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
| | - Tessa Schneeberger
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
| | - Inga Jarosch
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Rembert A. Koczulla
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
- German Center of Lung Research (DZL), Giessen-Marburg, Germany
| | - Klaus Kenn
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Dept of Pulmonary Rehabilitation, Philipps University Marburg, Marburg, Germany
- German Center of Lung Research (DZL), Giessen-Marburg, Germany
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Muñoz-Torrico M, Cid-Juárez S, Galicia-Amor S, Troosters T, Spanevello A. Tuberculosis sequelae assessment and rehabilitation. Tuberculosis (Edinb) 2018. [DOI: 10.1183/2312508x.10022317] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Hoffman M, Chaves G, Ribeiro-Samora GA, Britto RR, Parreira VF. Effects of pulmonary rehabilitation in lung transplant candidates: a systematic review. BMJ Open 2017; 7:e013445. [PMID: 28159852 PMCID: PMC5294003 DOI: 10.1136/bmjopen-2016-013445] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES The aim of this systematic review of randomised controlled trials (RCTs), and quasi-experimental and retrospective studies is to investigate the effects of pulmonary rehabilitation (PR) in patients with advanced chronic disease on the waiting list for lung transplantation. SETTING PR performed for inpatient or outpatient lung transplant candidates. INTERVENTION PR programme including aerobic exercise training and/or resistance exercise training. PRIMARY AND SECONDARY OUTCOMES Quality of life and exercise capacity (primary outcomes). Survival rate after transplant surgery; pulmonary function; respiratory muscle strength; psychological aspects; upper and lower extremity muscle strength and adverse effects (secondary outcomes). Two review authors independently selected the studies, assessed study quality and extracted data. Studies in any language were included. RESULTS This was a systematic review and studies were searched on the Cochrane Library, MEDLINE, EMBASE, CINAHL and PEDro. Experimental and retrospective studies evaluating the effects of PR in candidates for lung transplantation (>18 years old) with any lung diseases were included. 2 RCTs, and two quasi-experimental and two retrospectives studies, involving 1305 participants were included in the review. 5 studies included an enhancement reported in quality of life using the Short Form 36 questionnaire and showed improvements in some domains. All studies included exercise capacity evaluated through 6 min walk test and in five of them, there were improvements in this outcome after PR. Owing to the different characteristics of the studies, it was not possible to perform a meta-analysis. CONCLUSIONS Studies included in this review showed that PR is an effective treatment option for patients on the waiting list for lung transplantation and can improve quality of life and exercise capacity in those patients. Although individual studies reported positive effects of PR, this review shows that there is a need for more studies of a high methodological quality addressing PR effects in lung transplant candidates. TRIAL REGISTRATION NUMBER PROSPERO CDR42015025110.
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Affiliation(s)
- Mariana Hoffman
- Rehabilitation Sciences Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Gabriela Chaves
- Rehabilitation Sciences Program, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Ni HJ, Pudasaini B, Yuan XT, Li HF, Shi L, Yuan P. Exercise Training for Patients Pre- and Postsurgically Treated for Non-Small Cell Lung Cancer: A Systematic Review and Meta-analysis. Integr Cancer Ther 2016; 16:63-73. [PMID: 27151583 PMCID: PMC5736064 DOI: 10.1177/1534735416645180] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This meta-analysis examined the effects of exercise training on length of hospital stay, postoperative complications, exercise capacity, 6-minute walking distance (6MWD), and health-related quality of life (HRQoL) in patients following resection of non-small cell lung cancer (NSCLC). METHODS This review searched PubMed, EMBASE, and the Cochrane Collaboration data base up to August 16, 2015. It includes 15 studies comparing exercise endurance and quality of life before versus after exercise training in patients undergoing lung resection for NSCLC. RESULTS This review identified 15 studies, 8 of which are randomized controlled trials including 350 patients. Preoperative exercise training shortened length of hospital stay; mean difference (MD): -4.98 days (95% CI = -6.22 to -3.74, P < .00001) and also decreased postoperative complications for which the odds ratio was 0.33 (95% CI = 0.15 to 0.74, P = .007). Four weeks of preoperative exercise training improved exercise capacity; 6MWD was increased to 39.95 m (95% CI = 5.31 to 74.6, P = .02) .While postoperative exercise training can also effectively improve exercise capacity, it required a longer training period; 6MWD was increased to 62.83 m (95% CI = 57.94 to 67.72) after 12 weeks of training ( P < .00001). For HRQoL, on the EORTC-QLQ-30, there were no differences in patients' global health after exercise, but dyspnea score was decreased -14.31 points (95% CI = -20.03 to -8.58, P < .00001). On the SF-36 score, physical health was better after exercise training (MD = 3 points, 95% CI = 0.81 to 5.2, P = .007) while there was no difference with regard to mental health. The I2 statistics of all statistically pooled data were lower than 30%. There was a low amount of heterogeneity among these studies. CONCLUSIONS Evidence from this review suggests that preoperative exercise training may shorten length of hospital stay, decrease postoperative complications and increase 6MWD. Postoperative exercise training can also effectively improve both the 6MWD and quality of life in surgical patients with NSCLC, but requiring a longer training period.
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Affiliation(s)
- Hui-Juan Ni
- 1 Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bigyan Pudasaini
- 1 Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xun-Tao Yuan
- 2 Weifang Traditional Chinese Hospital, Shandong, China
| | - He-Fang Li
- 3 Laian Maternal and Child Health Care and Family Plaining Service Center, Chuzhou, Anhui, China
| | - Lei Shi
- 4 Zhejiang Cancer Hospital, Hangzhou City, Zhejiang, China
| | - Ping Yuan
- 1 Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
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Morano MTAP, Mesquita R, Da Silva GPF, Araújo AS, Pinto JMDS, Neto AG, Viana CMS, De Moraes Filho MO, Pereira EDB. Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial. BMC Pulm Med 2014; 14:121. [PMID: 25065540 PMCID: PMC4120009 DOI: 10.1186/1471-2466-14-121] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 07/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systemic inflammation plays an important role in the initiation, promotion, and progression of lung carcinogenesis. In patients with non-small cell lung cancer (NSCLC), fibrinogen levels correlate with neoplasia. Here we compared the effects of pulmonary rehabilitation (PR) with chest physical therapy (CPT) on fibrinogen and albumin levels in patients with LC and previous inflammatory lung disease awaiting lung resection. METHODS We conducted a randomized clinical trial with 24 patients who were randomly assigned to Pulmonary Rehabilitation (PR) and Chest Physical Therapy (CPT) groups. Each group underwent training 5 days weekly for 4 weeks. All patients were assessed before and after four weeks of training through clinical assessment, measurement of fibrinogen and albumin levels, spirometry, 6-minute Walk Test (6MWT), quality of life survey, and anxiety and depression scale. PR involved strength and endurance training, and CPT involved lung expansion techniques. Both groups attended educational classes. RESULTS A mixed between-within subjects analysis of variance (ANOVA) revealed a significant interaction between time (before and after intervention) and group (PR vs. CPT) on fibrinogen levels (F(1, 22)=0.57, p<0.0001) and a significant main effect of time (F(1, 22)=0.68, p=0.004). Changes in albumin levels were not statistically significant relative to the interaction effect between time and group (F(1, 22)=0.96, p=0.37) nor the main effects of time (F(1, 22)=1.00, p=1.00) and group (F(1, 22 )=0.59, p=0.45). A mixed between-within subjects ANOVA revealed significant interaction effects between time and group for the peak work rate of the unsupported upper limb exercise (F(1, 22)=0.77, p=0.02), endurance time (F(1, 22)=0.60, p=0.001), levels of anxiety (F(1, 22)=0.60, p=0.002) and depression (F(1, 22)=0.74, p=0.02), and the SF-36 physical component summary (F(1, 22)=0.83, p=0.07). CONCLUSION PR reduced serum fibrinogen levels, improved functional parameters, and quality of life of patients with LC and inflammatory lung disease awaiting lung resection. TRIAL REGISTRATION Current Controlled Trials RBR-3nm5bv.
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Santa Mina D, Guglietti CL, Alibhai SMH, Matthew AG, Kalnin R, Ahmad N, Lindner U, Trachtenberg J. The effect of meeting physical activity guidelines for cancer survivors on quality of life following radical prostatectomy for prostate cancer. J Cancer Surviv 2013; 8:190-8. [PMID: 24317972 DOI: 10.1007/s11764-013-0329-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/12/2013] [Indexed: 01/09/2023]
Affiliation(s)
- Daniel Santa Mina
- Kinesiology Program, The University of Guelph-Humber, Room GH-308-G, 207 Humber College Boulevard, Toronto, ON, Canada, M9W 5L7,
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Morano MT, Araújo AS, Nascimento FB, da Silva GF, Mesquita R, Pinto JS, de Moraes Filho MO, Pereira ED. Preoperative Pulmonary Rehabilitation Versus Chest Physical Therapy in Patients Undergoing Lung Cancer Resection: A Pilot Randomized Controlled Trial. Arch Phys Med Rehabil 2013; 94:53-8. [DOI: 10.1016/j.apmr.2012.08.206] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/05/2012] [Accepted: 08/09/2012] [Indexed: 11/17/2022]
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Pehlivan E, Turna A, Gurses A, Gurses HN. The Effects of Preoperative Short-term Intense Physical Therapy in Lung Cancer Patients:A Randomized Controlled Trial. Ann Thorac Cardiovasc Surg 2011; 17:461-8. [DOI: 10.5761/atcs.oa.11.01663] [Citation(s) in RCA: 92] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kanaan R. [Indications and contraindications to lung transplant: patient selection]. REVUE DE PNEUMOLOGIE CLINIQUE 2010; 67:5-14. [PMID: 21353968 DOI: 10.1016/j.pneumo.2010.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 12/27/2010] [Indexed: 05/30/2023]
Abstract
Lung transplant (LT) is a valid treatment for patients with end-stage lung disease such as cystic fibrosis, emphysema, pulmonary fibrosis and pulmonary arterial hypertension (85% of indications) and for selected candidates. The "good recipient" was introduced early to a specialised center, has had complete pre-LT assessment and complete information. At the end of this assessment, the absolute contraindications were eliminated (cardiovascular pathologies, recent neoplasia, active viral diseases, severe psychiatric disorders), advanced age risks were discussed, co-morbidities to treat were listed and an individualised therapeutic pre-LT program has been decided (based on exercise and muscle rehabilitation, nutritional support, anti-infectious treatments, active management of co-morbidities such as diabetes, hypertension, gastro-esophageal reflux…) with a psychological follow-up if necessary. Timely inscription on waiting list must be decided, early enough to avoid extreme handicap or risk pre-LT death, but not too early to have a survival benefit linked to LT. Death without LT prognosis criteria are still studied, and even if they do not fully define the risk of death of an individualised patient, they are taken into account by the recommendations of the societies; since 2006, LT indications are based on severity criteria of the selected patient, defined for each recipient diagnosis. LT aims to improve survival and quality of life of the patient, and this is especially true when the patient is referred, prepared and monitored early enough by the transplant team; the aim is to limit the risk of death before LT (before listing and on waiting list) and early post-LT morbimortality.
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Affiliation(s)
- R Kanaan
- Service de pneumologie, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
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Quand le pneumologue doit-il envisager la greffe pulmonaire pour un de ses patients adulte ? Indications, critères de sélection, préparation à la greffe. Rev Mal Respir 2008; 25:1251-9. [DOI: 10.1016/s0761-8425(08)75090-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Wright CD, Gaissert HA, Grab JD, O'Brien SM, Peterson ED, Allen MS. Predictors of Prolonged Length of Stay after Lobectomy for Lung Cancer: A Society of Thoracic Surgeons General Thoracic Surgery Database Risk-Adjustment Model. Ann Thorac Surg 2008; 85:1857-65; discussion 1865. [DOI: 10.1016/j.athoracsur.2008.03.024] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 03/06/2008] [Accepted: 03/10/2008] [Indexed: 10/22/2022]
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Abstract
The benefits derived from comprehensive PR, when applied to patients who have lung cancer, should have significant impact on both survival and health status. Because PR is known to improve exercise capacity, it is reasonable to expect that this treatment modality may provide more patients with a potential cure. In addition, improvement in symptoms and quality of life can prove critically important when long-term survival is not an outcome that can be impacted on. Studies thus far support the value of this treatment modality in the global approach to patients who have lung cancer. Future well-designed clinical trials will need to corroborate these findings. We look forward to improving lung cancer outcomes with the widespread use of pulmonary rehabilitation.
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Affiliation(s)
- Linda Nici
- Pulmonary and Critical Care Section, Providence Veterans Administration Medical Center, 830 Chalkstone Avenue, Providence, RI 02908, USA.
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Paull DE. Invited commentary. Ann Thorac Surg 2007; 84:202. [PMID: 17588412 DOI: 10.1016/j.athoracsur.2007.02.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Revised: 02/15/2007] [Accepted: 02/21/2007] [Indexed: 11/30/2022]
Affiliation(s)
- Douglas E Paull
- Department of Surgery, Wright State University Boonshoft School of Medicine, VA Medical Center, 4100 W. Third St, Dayton, OH 45428, USA.
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Reeve J, Denehy L, Stiller K. The physiotherapy management of patients undergoing thoracic surgery: a survey of current practice in Australia and New Zealand. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2007; 12:59-71. [PMID: 17536644 DOI: 10.1002/pri.354] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Physiotherapy is considered an essential component of the management of patients after thoracotomy, yet the type of interventions utilized, and evidence for their efficacy, has not been established. The aim of the present study was to ascertain the current physiotherapy management of patients undergoing thoracotomy and the factors influencing practice among different providers. METHOD A purpose-designed postal questionnaire was distributed to senior physiotherapists in all thoracic surgical units throughout Australia and New Zealand (n=57). RESULTS A response rate of 81% was obtained (n=46). Pre-operatively, 16 respondents (35%) reported assessing all thoracotomy patients. The majority of respondents (n=44; 96%) indicated that all patients were seen by physiotherapists after surgery, with 29 respondents (63%) performing prophylactic physiotherapy interventions to prevent post-operative pulmonary complications. Respondents reported that physiotherapy treatment was usually commenced on day one post-operatively (n=37; 80%) with the most commonly used treatment interventions being deep breathing exercises, the active cycle of breathing techniques, cough, forced expiration techniques and sustained maximal inspirations. Most respondents reported that patients first sat out of bed (n=41; 89%), commenced shoulder range of movement (n=23; 50%) and walking (n=32; 70%) on day one post-operatively. The majority of respondents reported that they offered no post-operative pulmonary rehabilitation (n=25; 54%), outpatient follow-up (n=43; 94%) orpost-thoracotomy pain management (n=40; 87%). Respondents indicated that personal experience, literature recommendations and established practice were the factors which most influenced physiotherapy practice. Conclusion. Most patients after thoracotomy receive physiotherapy assessment and/or treatment in the immediate post-operative period, but only one-third were routinely seen pre-operatively and relatively few were reviewed following discharge from hospital. Further studies are required to guide physiotherapists in determining the efficacy of their practices for patients undergoing thoracotomy.
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Affiliation(s)
- Julie Reeve
- School of Physiotherapy, Faculty of Health and Environmental Studies, Auckland University of Technology, Auckland, New Zealand.
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González Doniz L, Fernández Cervantes R, Souto Camba S, López García A. Abordaje fisioterápico en la cirugía por cáncer de pulmón. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/s0211-5638(06)74056-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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