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Yanagita Y, Arizono S, Tawara Y, Oomagari M, Machiguchi H, Tanahashi M, Katagiri N, Iida Y, Kozu R. Physical activity in patients with non-small cell lung cancer after lung resection. Clin Biomech (Bristol, Avon) 2024; 115:106249. [PMID: 38615547 DOI: 10.1016/j.clinbiomech.2024.106249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 03/31/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Lung resection is the standard of care for patients with clinical stage I/II non-small cell lung cancer. This surgery reduces both the duration and quality of patients' daily ambulatory activities 1 month after surgery. However, little is known about physical activity after lung resection in patients with lung cancer. To evaluate the recovery process of physical activity with pulmonary rehabilitation in patients after lung resection and examine whether physical activity is affected by age. METHODS In this prospective, observational study, we measured and analysed participants' postoperative physical activity using a uniaxial accelerometer daily from postoperative day 1 to 30. FINDINGS We analysed 99 patients who underwent thoracic surgery. The number of walking steps significantly increased until day 4 and then reached a plateau thereafter. The duration of exercise at <3 metabolic equivalents significantly increased until day 3, and no significant difference was observed thereafter. Exercise at >3 metabolic equivalents significantly increased until day 4 and reached a plateau thereafter. A significant correlation was observed between age and number of steps after day 4. Compared with video-assisted thoracoscopic surgery, thoracotomy significantly decreased the number of steps from day 3 to 4. INTERPRETATION We found that the level of physical activity varied by index in patients with non-small cell lung cancer who underwent lung resection. Age and surgical procedure affect different periods with the increase in post-operative walking steps.
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Affiliation(s)
- Yorihide Yanagita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki Prefecture 852-8520, Japan
| | - Shinichi Arizono
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, 3453 Mikatahara-cho, Hamamatsu City, Shizuoka Prefecture 433-8558, Japan.
| | - Yuichi Tawara
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, 3453 Mikatahara-cho, Hamamatsu City, Shizuoka Prefecture 433-8558, Japan
| | - Masaki Oomagari
- Department of Rehabilitation, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Hamamatsu City, Shizuoka Prefecture 433-8558, Japan
| | - Hikaru Machiguchi
- Department of Rehabilitation, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama, Kanagawa 236-0051, Japan
| | - Masayuki Tanahashi
- Division of Thoracic Surgery, Respiratory Disease Centre, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Hamamatsu City, Shizuoka Prefecture 433-8558, Japan
| | - Norimasa Katagiri
- Department of Rehabilitation Medicine, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Hamamatsu City, Shizuoka Prefecture 433-8558, Japan
| | - Yuki Iida
- Department of Physical Therapy, School of Health Science, Toyohashi Sozo University, 20-1 Matsushita, Ushikawa-cho, Toyohashi City, Aichi Prefecture 440-8511, Japan
| | - Ryo Kozu
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki Prefecture 852-8520, Japan
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Syversen A, Dosis A, Jayne D, Zhang Z. Wearable Sensors as a Preoperative Assessment Tool: A Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:482. [PMID: 38257579 PMCID: PMC10820534 DOI: 10.3390/s24020482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024]
Abstract
Surgery is a common first-line treatment for many types of disease, including cancer. Mortality rates after general elective surgery have seen significant decreases whilst postoperative complications remain a frequent occurrence. Preoperative assessment tools are used to support patient risk stratification but do not always provide a precise and accessible assessment. Wearable sensors (WS) provide an accessible alternative that offers continuous monitoring in a non-clinical setting. They have shown consistent uptake across the perioperative period but there has been no review of WS as a preoperative assessment tool. This paper reviews the developments in WS research that have application to the preoperative period. Accelerometers were consistently employed as sensors in research and were frequently combined with photoplethysmography or electrocardiography sensors. Pre-processing methods were discussed and missing data was a common theme; this was dealt with in several ways, commonly by employing an extraction threshold or using imputation techniques. Research rarely processed raw data; commercial devices that employ internal proprietary algorithms with pre-calculated heart rate and step count were most commonly employed limiting further feature extraction. A range of machine learning models were used to predict outcomes including support vector machines, random forests and regression models. No individual model clearly outperformed others. Deep learning proved successful for predicting exercise testing outcomes but only within large sample-size studies. This review outlines the challenges of WS and provides recommendations for future research to develop WS as a viable preoperative assessment tool.
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Affiliation(s)
- Aron Syversen
- School of Computing, University of Leeds, Leeds LS2 9JT, UK
| | - Alexios Dosis
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.D.); (D.J.)
| | - David Jayne
- School of Medicine, University of Leeds, Leeds LS2 9JT, UK; (A.D.); (D.J.)
| | - Zhiqiang Zhang
- School of Electrical Engineering, University of Leeds, Leeds LS2 9JT, UK;
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3
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Raz DJ, Kim JY, Erhunwmunesee L, Hite S, Varatkar G, Sun V. The value of perioperative physical activity in older patients undergoing surgery for lung cancer. Expert Rev Respir Med 2023; 17:691-700. [PMID: 37668168 DOI: 10.1080/17476348.2023.2255133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/24/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION With a median age at diagnosis of 70, lung cancer represents an enormous public health problem among older Americans. An estimated 19,000 people age 65 and older undergo lung cancer surgery annually in the US. Older adults undergoing lung cancer surgery are often frail with limited physiologic reserves, multi-morbidities, and functional impairments. Physical function, dyspnea, and quality of life return to baseline slower in older adults compared with younger adults after lung surgery. AREAS COVERED In this review, we summarize available data about perioperative physical activity interventions that may improve outcomes for older adults undergoing lung cancer surgery. We also review the limitations of existing studies and discuss emerging data on the roles of telehealth and family caregiver inclusion in peri-operative physical activity interventions. EXPERT OPINION We propose that future perioperative physical activity interventions in older adults undergoing lung cancer surgery should include a comprehensive geriatric assessment to guide personalized interventions. Interventions should be conceptually based, with a focus on enhancing self-efficacy, motivation, and adherence through classic behavior change strategies that are proven to impact outcomes. Finally, interventions should be designed with attention to feasibility and scalability. Exercise programs delivered via telehealth (telephone or tele-video) may improve access and convenience for patients.
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Affiliation(s)
- Dan J Raz
- Department of Surgery, City of Hope, CA, USA
| | - Jae Y Kim
- Department of Surgery, City of Hope, CA, USA
| | - Loretta Erhunwmunesee
- Department of Surgery, City of Hope, CA, USA
- Department of Population Sciences, City of Hope, CA, USA
| | - Sherry Hite
- Department of Rehabilitation, City of Hope, CA, USA
| | | | - Virginia Sun
- Department of Surgery, City of Hope, CA, USA
- Department of Population Sciences, City of Hope, CA, USA
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4
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Comprehensive assessment of postoperative mobility during the first days after mini-invasive lung surgery: A prospective observational study. J Clin Anesth 2023; 86:111048. [PMID: 36716650 DOI: 10.1016/j.jclinane.2022.111048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/29/2022] [Accepted: 12/28/2022] [Indexed: 01/30/2023]
Abstract
STUDY OBJECTIVE Postoperative physical therapy and early mobilization are major elements for enhanced recovery after surgery. In contrast with supervised physical therapy sessions that can be monitored, self-mobilization is not easily quantifiable and has so far been estimated mainly through patient auto-reports. This study aimed to perform a comprehensive and objective evaluation of postoperative mobility. DESIGN Prospective observational study. SETTING Postoperative setting. PATIENTS Patients undergoing mini-invasive lung surgery. INTERVENTIONS Measurement of postoperative mobility during the first five postoperative days using an accelerometer (ActiGraph GT3X). MEASUREMENTS The primary outcome was the number of daily steps. Secondary outcomes included physical activity duration and intensity, sedentary time, number of breaks in sedentary time, sedentary patterns, daily evaluation by physiotherapists, postoperative complications, and acceptability of wearing the accelerometer. MAIN RESULTS Sixty patients were included in the study, of whom 56 provided at least one day of valid accelerometry data. There was no significant change during the first four PODs concerning the number of daily steps nor the mean cadence. One-minute cadence peak, total activity counts, and duration of light-intensity physical activity increased over time (p = 0.032, p = 0.001 and p = 0.001, respectively). Sedentary patterns changed favorably over time, with a decrease in prolonged sedentary bouts (≥ 60 consecutive min) (p < 0.001), and an increase in shorter bouts (< 10 min) (p = 0.001). Similar results were observed when analysis was adjusted for the day of the week when the surgery took place. The median acceptability of wearing the accelerometer was excellent (median 10 [9-10] on a 10-point Likert scale). Three patients had major complications. CONCLUSIONS Our findings suggest that daily steps may not be the only relevant indicator of early mobility following thoracic surgery and that accelerometry is suitable to follow patients' early postoperative activity.
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Jin Z, Lee C, Zhang K, Jeong R, Gan TJ, Richman DC. Utilization of Wearable Pedometer Devices in the Perioperative Period: A Qualitative Systematic Review. Anesth Analg 2023; 136:646-654. [PMID: 36928149 DOI: 10.1213/ane.0000000000006353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Functional capacity assessment is important for perioperative risk stratification; however, there are currently limited options for objective and economical functional capacity evaluation. Pedometer functions are now widely available in mobile devices and offer a nonintrusive and objective approach to measuring patient activity level over time. Therefore, we conducted this systematic review to assess the value of pedometer readings in predicting perioperative outcomes. We systematically searched PubMed, EMBASE (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science Citation Index for studies, which assessed the correlation between perioperative (30 days before to 30 days after surgery) pedometer data and perioperative outcomes. We identified a total of 18 studies for inclusion. Seven of the studies recorded preoperative pedometer data, and 13 studies recorded postoperative pedometer data. Notably, 10 of the studies covered oncologic surgery patients. The included studies consistently reported that preoperative pedometer readings correlated with postoperative complication rates. In addition, in-hospital postoperative pedometer readings correlated with postdischarge complications and readmissions. Perioperative pedometer data demonstrated consistent and biologically plausible association with perioperative outcomes. Further studies are needed to validate the use of pedometer in the perioperative period and to identify the optimal approach for its use to potentially improve patient outcomes.
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Affiliation(s)
- Zhaosheng Jin
- From the Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Christopher Lee
- From the Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Kalissa Zhang
- From the Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Rosen Jeong
- Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Tong J Gan
- From the Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
| | - Deborah C Richman
- From the Department of Anesthesiology, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York
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6
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Zhou W, Webster KE, Smith EL, Chen W, Veliz PT, Reddy RM, Larson JL. Physical activity in surgical lung cancer patients: a systematic review. Support Care Cancer 2022; 30:6473-6482. [PMID: 35384612 DOI: 10.1007/s00520-022-07018-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/25/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Perioperative exercise could improve health outcomes of surgical lung cancer patients, but less is known about their natural physical activity (PA) behavior before exercise interventions. This review aimed to synthesize evidence on PA, regarding the following: (1) proportion of patients meeting PA guidelines, (2) amount of PA, (3) PA trajectory following surgery, and (4) correlates of PA before or after surgery. METHODS We conducted a systematic review using PubMed, CINHAL, Scopus, and SPORTDiscus (July 2021). Observational or experimental studies that measure PA of lung cancer patients before/after surgery were included. We assessed methodological quality using the NIH Quality Assessment Tools and extracted data using a standardized form. RESULTS Seventeen studies (25 articles, N = 1737 participants) published between 2009 and 2021 were included. Fourteen studies had sample sizes less than 100. Thirteen studies were of fair quality and four studies were of good quality. Only 23-28% of patients met PA guideline (150 min/week moderate-vigorous PA) at 6 months-6 years after surgery. Patients took an average of 3822-10,603 daily steps before surgery and 3934-8863 steps at 1-3 months after surgery. Physical activity was lower at 1 day-3 months after surgery, compared with preoperative levels. Perioperative PA was positively associated with exercise capacity, quality of life and reduced postoperative complications. CONCLUSION This review suggests that PA is low among surgical lung cancer patients, and it may not recover within 3 months following surgery. Physical activity has the potential to improve postoperative outcomes. However, the existing evidence is weak, and future larger longitudinal studies are needed.
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Affiliation(s)
- Weijiao Zhou
- School of Nursing, University of Michigan, Ann Arbor, MI, USA.
| | | | - Ellen Lavoie Smith
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Weiyun Chen
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Philip T Veliz
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Rishindra M Reddy
- Department of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Janet L Larson
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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7
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Kuroyama Y, Geshi E. Preoperative Physical Inactivity Affects the Postoperative Course of Surgical Patients with Lung Cancer. Phys Ther Res 2022; 24:256-263. [PMID: 35036260 DOI: 10.1298/ptr.e10127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Preoperative performance status is an important factor in thoracic surgery, but little is known about the effect of preoperative physical activity (PA) on the postoperative course. This study investigated the associations between preoperative PA and postoperative complications and clinical outcomes of lung cancer surgery. METHODS This prospective observational study included patients who underwent surgery for lung cancer at a single institution. PA was measured before hospitalization for 5 consecutive days and then after surgery until hospital discharge. The daily step count and time spent performing moderate intensity activity (> 3 metabolic equivalents) were measured with an accelerometer. We examined the correlations between PA and preoperative pulmonary function and physical fitness, and examined the relationship between postoperative complication and PA. Finally, a multivariate analysis was performed with pre-hospital PA as the dependent variable. RESULTS Forty-two patients were analyzed. Univariate analysis found no correlation between pre-hospital PA and preoperative pulmonary function, but found significant positive correlations between pre-hospital PA and time spent performing moderate intensity activity, in-hospital PA, preoperative 6-minute walk distance, and maximum gait speed (r > 0.5, p < 0.01). The nine patients who developed postoperative complications had significantly lower pre-hospital and postoperative step count than the patients with no complication (p = 0.04). Multiple regression analysis showed that pre-hospital PA was significantly associated with time spent performing moderate intensity activity, maximum gait speed, and postoperative complication. CONCLUSIONS Evaluation of pre-hospital PA is useful in predicting the postoperative course after lung cancer surgery.
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Affiliation(s)
- Yuki Kuroyama
- School of Nursing and Rehabilitation Sciences, Showa University, Japan.,Department of Rehabilitation, Showa General Hospital, Japan
| | - Eiichi Geshi
- School of Nursing and Rehabilitation Sciences, Showa University, Japan
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8
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Novoa NM, Esteban P, Gómez Hernández MT, Fuentes MG, Varela G, Jiménez MF. Early exercise pulmonary diffusing capacity of carbon monoxide after anatomical lung resection: a word of caution for fast-track programmes. Eur J Cardiothorac Surg 2020; 56:143-149. [PMID: 30726898 DOI: 10.1093/ejcts/ezz007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/10/2018] [Accepted: 12/16/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES In healthy individuals, increasing pulmonary blood flow during exercise also increases the % of the diffusing capacity of the lungs for carbon monoxide (DLCO%), but its evolution after lung resection is unknown. In this study, our goal was to measure changes in exercise DLCO% during the first 3 days after anatomical lung resection. METHODS We performed a prospective observational study on consecutive patients with non-small-cell lung cancer scheduled for anatomical resection, except pneumonectomy, during a 6-month period. Patients underwent measurement of the DLCO% by a single-breath technique adjusted by the concentration of haemoglobin-before and after standardized exercise the day before and 3 consecutive days after surgery. The delta (Δ) variation (basal versus exercise) was calculated. The number of functioning resected segments was calculated by bronchoscopy. Postoperative pain and pleural air leak were estimated using a visual analogue scale and graduated conventional pleural drainage systems, respectively, and their influence on ΔDLCO each postoperative day was evaluated by linear regression analysis. RESULTS Fifty-seven patients were included. The visual analogue scale of pain and pleural air leaks were not correlated to Δ values (model R2: 0.0048). The evolution of Δ values during 3 postoperative days showed a progressive recovery of values, but on the third day, DLCO% capacity during exercise was still impaired (P < 0.01), especially in patients who underwent a resection of more than 3 functioning segments. CONCLUSIONS Physiological increase in DLCO% during exercise is still impaired on the third postoperative day in patients undergoing resection of more than 3 functioning pulmonary segments. This fact should be considered before discharging those patients after anatomical lung resection.
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Affiliation(s)
- Nuria M Novoa
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Pedro Esteban
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Maria Teresa Gómez Hernández
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Marta G Fuentes
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Gonzalo Varela
- Institute of Biomedical Research of Salamanca. Salamanca, Spain
| | - Marcelo F Jiménez
- Thoracic Surgery Service, Institute of Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
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Novoa NM, Fuentes MG. Digital chest drainage vs. water seal chest drainage in the robotic era. J Thorac Dis 2020; 12:3004-3006. [PMID: 32642219 PMCID: PMC7330785 DOI: 10.21037/jtd.2020.03.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nuria M Novoa
- Thoracic Surgery Department, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research (IBSAL), Salamanca, Spain
| | - Marta G Fuentes
- Thoracic Surgery Department, Salamanca University Hospital, Salamanca, Spain.,Salamanca Institute of Biomedical Research (IBSAL), Salamanca, Spain
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10
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Nakajima H, Yokoyama Y, Inoue T, Nagaya M, Mizuno Y, Kayamoto A, Nishida Y, Nagino M. How Many Steps Per Day are Necessary to Prevent Postoperative Complications Following Hepato-Pancreato-Biliary Surgeries for Malignancy? Ann Surg Oncol 2020; 27:1387-1397. [PMID: 31974713 DOI: 10.1245/s10434-020-08218-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE The current study was designed to investigate the association between the average preoperative physical activity and postoperative outcomes in patients undergoing surgeries for hepato-pancreato-biliary (HPB) malignancy. METHODS Patients who were scheduled to undergo open abdominal surgeries for HPB malignancies (major hepatectomy, pancreatoduodenectomy, or hepato-pancreatoduodenectomy) between 2016 and 2017 were included. The average steps per day were recorded by a pedometer and calculated for each patient during the preoperative waiting period. Physical activity levels were classified according to the average number of daily steps as poor (< 5000 steps/day) and good (≥ 5000 steps/day). RESULTS Of the 105 eligible patients, 78 met the inclusion criteria. The median number of steps per day was 6174. There were 48 patients (62%) with good physical activity and 30 patients (38%) with poor physical activity. Patients with poor physical activity revealed a significantly higher rate of major complications with Clavien grade ≥ 3 (63% vs. 35%, p = 0.016), a higher rate of infectious complications (53% vs. 23%, p = 0.006), and a longer postoperative hospital stay (median, 30 vs. 21 days, p < 0.001) compared with those with good physical activity. After a multivariate analysis, poor physical activity was identified as an independent risk factor for the development of major complications (odds ratio, 2.842, p = 0.042) and infectious complications (odds ratio, 3.844, p = 0.007). CONCLUSIONS The current study demonstrated that preoperative physical activity levels are associated with the incidence of major postoperative complications following HPB surgery for malignancy.
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Affiliation(s)
- Hiroki Nakajima
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yukihiro Yokoyama
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
| | - Takayuki Inoue
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Motoki Nagaya
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yota Mizuno
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Azusa Kayamoto
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan
| | - Masato Nagino
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Jonsson M, Hurtig-Wennlöf A, Ahlsson A, Vidlund M, Cao Y, Westerdahl E. In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial. Physiotherapy 2019; 105:434-441. [DOI: 10.1016/j.physio.2018.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/04/2018] [Indexed: 02/07/2023]
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12
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Li X, Li S, Yan S, Wang Y, Wang X, Sihoe ADL, Yang Y, Wu N. Impact of preoperative exercise therapy on surgical outcomes in lung cancer patients with or without COPD: a systematic review and meta-analysis. Cancer Manag Res 2019; 11:1765-1777. [PMID: 30858729 PMCID: PMC6387612 DOI: 10.2147/cmar.s186432] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objectives This meta-analysis aimed to demonstrate the impact of preoperative exercise therapy on surgical outcomes in patients with lung cancer and COPD. Pulmonary function and muscle capacity were investigated to explore their potential links with outcome improvements after exercise. Methods Articles were searched from PubMed, Embase, and the Cochrane Library with criteria of lung cancer patients with or without COPD, undergoing resection, and receiving preoperative exercise training. Key outcomes were analyzed using meta-analysis. Results Seven studies containing 404 participants were included. Patients receiving preoperative exercise training had a lower incidence of postoperative pulmonary complications (PPCs; OR 0.44, 95% CI 0.27-0.71) and shorter length of hospital stay (standardized mean difference -4.23 days, 95% CI -6.14 to -2.32 days). Exceptionally, pneumonia incidence remained unchanged. Patients with COPD could not obviously benefit from exercise training to reduce PPCs (OR 0.44, 95% CI 0.18-1.08), but still might achieve faster recovery. No significant difference in pulmonary function was observed between the two groups. However, 6MWD and VO2 peak were significantly improved after exercise training. Conclusion Preoperative exercise training may reduce PPCs for lung cancer patients. However, for patients with COPD undergoing lung cancer resection, the role of exercise is uncertain, due to limited data, which calls for more prospective trials on this topic. Rehabilitation exercise strengthens muscle capacity, but does not improve impaired pulmonary function, which emphasizes the possible mechanism of the protocol design.
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Affiliation(s)
- Xiang Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
| | - Shaolei Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
| | - Shi Yan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
| | - Yaqi Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
| | - Xing Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
| | - Alan D L Sihoe
- Department of Surgery, University of Hong Kong, Hong Kong
| | - Yue Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
| | - Nan Wu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Surgery II, Peking University Cancer Hospital and Institute, Beijing, China,
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Kaplan SJ, Trottman PA, Porteous GH, Morris AJ, Kauer EA, Low DE, Hubka M. Functional Recovery After Lung Resection: A Before and After Prospective Cohort Study of Activity. Ann Thorac Surg 2019; 107:209-216. [DOI: 10.1016/j.athoracsur.2018.07.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/15/2018] [Accepted: 07/30/2018] [Indexed: 01/01/2023]
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14
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Twomey R, Bebb G, Culos-Reed SN. Health-related quality of life after curative-intent treatment of non-small cell lung cancer: can exercise lessen the burden? ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:S76. [PMID: 30613651 DOI: 10.21037/atm.2018.10.51] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rosie Twomey
- Faculty of Kinesiology, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Gwyn Bebb
- Department of Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Tom Baker Cancer Centre, Alberta Health Services, Alberta, Canada
| | - S Nicole Culos-Reed
- Faculty of Kinesiology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Alberta, Canada.,Tom Baker Cancer Centre, Alberta Health Services, Alberta, Canada
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Brocki BC, Andreasen JJ, Westerdahl E. Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level. Integr Cancer Ther 2018; 17:1095-1102. [PMID: 30136589 PMCID: PMC6247561 DOI: 10.1177/1534735418796286] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objectives. To describe postoperative self-reported physical activity (PA) level and assess the effects of 2 weeks of postoperative inspiratory muscle training (IMT) in patients at high risk for postoperative pulmonary complications following lung resection. Methods. This is a descriptive study reporting supplementary data from a randomized controlled trial that included 68 patients (mean age = 70 ± 8 years), randomized to an intervention group (IG; n = 34) or a control group (CG; n = 34). The IG underwent 2 weeks of postoperative IMT added to a standard postoperative physiotherapy given to both groups. The standard physiotherapy consisted of breathing exercises, coughing techniques, and early mobilization. We evaluated self-reported physical activity (Physical Activity Scale 2.1 questionnaire) and health status (EuroQol EQ-5D-5L questionnaire), assessed the day before surgery and 2 weeks postoperatively. Results. A significant percentage of the patients in the IG reported less sedentary activity 2 weeks postoperatively when compared with the CG (sedentary 6% vs 22%, low activity 56% vs 66%, moderate activity 38% vs 12%, respectively; P = .006). The mean difference in EQ-5D-5L between the IG and CG 2 weeks postoperatively was nonsignificant (P = .80). The overall preoperative EQ-5D-5L index score for the study population was comparable to a reference population. Conclusion. Postoperative IMT seems to prevent a decline in PA level 2 weeks postoperatively in high-risk patients undergoing lung resection. More research is needed to confirm these findings.
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