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Fram J, Boss K, Villaflor V, Jayabalan P. Barriers to and enablers of physical activity participation in lung cancer survivors. PM R 2024. [PMID: 38874321 DOI: 10.1002/pmrj.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/21/2024] [Accepted: 04/03/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Although physical activity physical activity has been shown to have significant benefits for individuals living with cancer, engaging lung cancer survivors (LCS) in increasing routine physical activity participation has been particularly challenging. PURPOSE To describe enablers of, barriers to, and patterns of physical activity among LCS and to characterize interest in a physical activity program as a first step to improving physical activity engagement. METHODS The study consisted of a cross-sectional survey (n = 100) of adult LCS recruited from a thoracic oncology clinic assessing multiple domains of physical activity (engagement, perceived barriers, benefits, physical function, psychosocial factors, self-efficacy, and programmatic preferences). RESULTS Only 12% of LCS in our cohort (average age 67 years, 54% male, 81% with stage III or IV disease) met American College of Sports Medicine (ACSM) physical activity guidelines. Participants engaged in moderate-to-vigorous physical activity, with an average (SD) of 48.4 (91.8) minutes per week. The most commonly reported barriers to physical activity were fatigue (49%), dyspnea (39%), and difficulty with daily activities (34%). Regression analysis demonstrated a positive association between moderate-to-vigorous physical activity and higher income (r = 0.241, p = .016), physical function (r = 0.281, p = .005), and physical activity self-efficacy (r = 0.270, p = .007). Qualitative results demonstrated a strong interest in physical activity programming that is lung-cancer specific with a high level of support and guidance. CONCLUSION This study identified that LCS had low levels of physical activity with fatigue, dyspnea, socioeconomic, and functional limitations contributing. The majority of LCS are interested in an exercise program and believe that exercise engagement will produce functional benefits. The present study presents a framework to guide development of community-based interventions to increase LCS physical activity participation among LCS.
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Affiliation(s)
- Julia Fram
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Victoria Villaflor
- Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA
| | - Prakash Jayabalan
- Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA
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Edbrooke L, Granger CL, Francis JJ, John T, Kaadan N, Halloran E, Connolly B, Denehy L. Rehabilitation outcomes for people with lung cancer (UNITE): protocol for the development of a core outcome set. BMJ Open Respir Res 2023; 10:e001571. [PMID: 37336620 PMCID: PMC10347493 DOI: 10.1136/bmjresp-2022-001571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 05/30/2023] [Indexed: 06/21/2023] Open
Abstract
INTRODUCTION With treatment-related improvements in survival, rehabilitation is essential to improve function and health-related quality of life and manage the high symptom burden associated with lung cancer. Despite this, significant heterogeneity exists in the outcomes and instruments used to evaluate lung cancer rehabilitation programme impact. This study aims to develop a core set of clinically relevant lung cancer rehabilitation outcomes for use in clinical practice. METHODS AND ANALYSIS An international Delphi consensus study involving consumer, healthcare professional and researcher stakeholders to determine which outcomes to include and how to measure these. Stage 1 (preliminary): mixed methods to develop the potential list of outcomes (1) overview of systematic reviews of lung cancer exercise interventions and (2) focus groups and individual interviews with people with lung cancer. Stage 2: outcomes were grouped according to the International Classification of Functioning, Disability and Health domains. Stage 3: to determine priority outcomes for core outcome set (COS) inclusion participants will rate each outcome's importance (one-nine-point Likert scale) over two-three survey rounds. Stage 4: following review by the steering committee, a consensus meeting will be held if agreement on the COS has not been reached.Stage 5: recommendations will be made regarding a single instrument for measuring each COS outcome by reviewing existing resources where consensus has already been reached. Where resources do not exist the quality and feasibility of potential measurement instruments will be appraised, and the Delphi consensus survey and meeting process outlined in stages 3-4 will be repeated.This protocol adheres to the COS-Standardised Protocol statement and will be conducted and reported according to the COS-Standards for Development recommendations and the COS-Standards for Reporting. ETHICS AND DISSEMINATION Ethics approval (20/9/22, University of Melbourne ID 2022-24839-32231-3). Dissemination in peer-reviewed journals and conference presentations.
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Affiliation(s)
- Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Physiotherapy, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Jill J Francis
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tom John
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nasreen Kaadan
- Consumer Representative, Sydney, New South Wales, Australia
| | - Emma Halloran
- Lung Foundation Australia, Milton, Queensland, Australia
| | - Bronwen Connolly
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, County Antrim, UK
| | - Linda Denehy
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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Ch’ng SN, McVeigh JA, Manners D, Boyle T, Peddle-McIntyre CJ, Thomas R, Leong J, Bowyer S, Mooney K, Straker L, Galvão DA, Cavalheri V. Sedentary Behaviour, Physical Activity, and Their Associations with Health Outcomes at the Time of Diagnosis in People with Inoperable Lung Cancer. J Clin Med 2022; 11:jcm11195870. [PMID: 36233738 PMCID: PMC9572651 DOI: 10.3390/jcm11195870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
This study aimed to examine sedentary behaviour (SB), physical activity (PA) and their associations with health-related measures at the time of diagnosis in people with inoperable lung cancer. People newly diagnosed with inoperable lung cancer were invited to participate in the study and asked to wear an accelerometer for seven consecutive days. Variables analysed included time spent in SB, light intensity PA (LIPA) and moderate-to-vigorous intensity PA (MVPA). Daily steps were also recorded. Data on symptoms, health-related quality of life (HRQoL), hand grip force, comorbidities and lung function were collected. Of the 120 patients referred to the study, 89 (74%) consented to participate, and SB/PA data were available for 79 (age 71 ± 11 years; 29 females). Participants spent 71% of their waking time in SB, 28% in LIPA and 1% in MVPA. Regression models demonstrated that increased SB was associated with more symptoms of fatigue and dyspnoea (p ≤ 0.02 for both), poorer HRQoL (general health and physical component score; p ≤ 0.02 for all) and lower hand grip force. For PA variables, higher daily step count was associated with better scores in all health-related measures (p < 0.05 for all). LIPA was associated with more health-related outcomes than MVPA. These findings may guide future interventions in this population.
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Affiliation(s)
- Shu Ning Ch’ng
- Curtin School of Allied Health, Curtin University, Perth 6845, Australia
| | - Joanne A. McVeigh
- Curtin School of Allied Health, Curtin University, Perth 6845, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth 6845, Australia
| | - David Manners
- St John of God Midland Public and Private Hospitals, Perth 6056, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia Cancer Research Institute, Adelaide 5000, Australia
| | | | - Rajesh Thomas
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth 6009, Australia
| | - Jeanie Leong
- Department of Respiratory Medicine, Royal Perth Hospital, Perth 6000, Australia
| | - Samantha Bowyer
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth 6009, Australia
| | - Kirsten Mooney
- WA Cancer and Palliative Care Network, North Metropolitan Health Service, Perth 6009, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth 6845, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth 6845, Australia
| | - Daniel A. Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth 6027, Australia
| | - Vinicius Cavalheri
- Curtin School of Allied Health, Curtin University, Perth 6845, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth 6845, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth 6027, Australia
- Allied Health, South Metropolitan Health Service, Perth 6009, Australia
- Correspondence:
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Ogura R, Iribe S, Suzuki T, Kuroda H, Sugisawa T, Okuni I, Otsuka H, Azuma Y, Iyoda A, Ebihara S. Persistence of the Postoperative Change in the Six-minute Walking Distance of Lung Cancer Patients with Chronic Obstructive Pulmonary Disease. Prog Rehabil Med 2021; 6:20210022. [PMID: 34013089 PMCID: PMC8103386 DOI: 10.2490/prm.20210022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 04/22/2021] [Indexed: 11/22/2022] Open
Abstract
Objectives: The aim of this prospective follow-up study was to investigate the difference before
and after surgery in the six-minute walking distance (6MD) of lung cancer patients with
chronic obstructive pulmonary disease (COPD) and to examine the long-term effect of the
change in 6MD in the early postoperative period. Methods: This was a retrospective analysis of 25 COPD patients who underwent lung cancer surgery
and perioperative rehabilitation in our department. Assessments of 6WD were carried out
preoperatively and at 1, 3, and 6 months postoperatively. The changes in 6MD at 1, 3,
and 6 months postoperatively compared with the preoperative value were designated the
1-month Δ6MD, the 3-month Δ6MD, and the 6-month Δ6MD, and the associations between them
were investigated. Results: The mean 6MD distance was 412.0±27.3 m (95% confidence interval) preoperatively,
369.0±33.8 m at 1 month, 395.6±32.2 m at 3 months, and 400.0±38.2 m at 6 months, with a
significant difference between the preoperative and 1-month values (P<0.01). There
were strong correlations between 1-month and 3-month Δ6MDs (r =0.74,
P<0.0001) and between 1-month and 6-month Δ6MDs (r =0.88,
P<0.0001). Conclusions: In lung cancer patients with COPD, the 1-month Δ6MD was strongly associated with both
the 3-month Δ6MD and the 6-month Δ6MD. These findings suggest that the decrease in
exercise tolerance of patients whose 6MD is low at 1 month postoperatively may be
prolonged, and such patients may therefore be in greater need of postoperative
outpatient rehabilitation.
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Affiliation(s)
- Ryoji Ogura
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Shunsuke Iribe
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Takahiko Suzuki
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Haruka Kuroda
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Tatsuki Sugisawa
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Ikuko Okuni
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
| | - Hajime Otsuka
- Department of Chest Surgery, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Yoko Azuma
- Department of Chest Surgery, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Akira Iyoda
- Department of Chest Surgery, School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Satoru Ebihara
- Department of Rehabilitation Medicine, Toho University Omori Medical Center, Tokyo, Japan
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Koller M, Shamieh O, Hjermstad MJ, Hornslien K, Young T, Chalk T, Ioannidis G, Harle A, Johnson CD, Tomaszewski KA, Serpentini S, Pinto M, van der Weijst L, Janssens A, Morag O, Chie WC, Arraras JI, Pompili C, Jungraithmayr W, Hechtner M, Katsochi D, Müller K, Gräfenstein L, Schulz C, Bottomley A. Psychometric properties of the updated EORTC module for assessing quality of life in patients with lung cancer (QLQ-LC29): an international, observational field study. Lancet Oncol 2020; 21:723-732. [PMID: 32213338 DOI: 10.1016/s1470-2045(20)30093-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Lung Cancer 13 (QLQ-LC13) assesses quality of life (QOL) in patients with lung cancer and was the first EORTC module developed for use in international clinical trials. Since its publication in 1994, major treatment advances with possible effects on QOL have occurred. These changes called for an update of the module and its international psychometric validation. We aimed to investigate the scale structure and psychometric properties of the updated lung cancer module, QLQ-LC29, in patients with lung cancer. METHODS This international, observational field study was done in 19 hospitals across 12 countries. Patients aged older than 18 years with a confirmed diagnosis of lung cancer and no other previous primary tumour, and who were mentally fit with sufficient language skills to understand and complete the questionnaire were included. Patients were asked during a hospital visit to fill in the paper versions of the core questionnaire EORTC QLQ-C30 plus QLQ-LC29, and investigators selected half of these patients to complete the questionnaire again 2-4 weeks later. Our primary aim was to assess the scale structure and psychometric properties of EORTC QLQ-LC29. We analysed scale structure using confirmatory factor analysis; reliability using Cronbach's α value (internal consistency) and intra-class coefficient (test-retest reliability); sensitivity using independent t tests stratified by Karnofsky performance status; and responsiveness to change over time by ANOVA. This study is registered with ClinicalTrials.gov, NCT02745691. FINDINGS Between April 12, 2016, and Sept 26, 2018, 523 patients with a confirmed diagnosis of either non-small-cell lung cancer (n=442) or small-cell lung cancer (n=81) were recruited. Confirmatory factor analysis provided a solution composed of five multi-item scales (coughing, shortness of breath, fear of progression, hair problems, and surgery-related symptoms) plus 15 single symptom or side-effect items: χ2=370·233, root mean square error of approximation=0·075, and comparative-fit index=0·901. Cronbach's α for internal consistencies of all multi-item scales were above the threshold of 0·70. Intra-class coefficients for test-retest reliabilities ranged between 0·82 and 0·97. Three (shortness of breath, fear of progression, and hair problems) of the five multi-item scales showed responsiveness to change over time (p values <0·05), as did nine of 15 single symptom items. Four (coughing, shortness of breath, fear of progression, and surgery-related symptoms) of the five multi-item scales and ten of the 15 single symptom items were sensitive to known group differences (ie, lower vs higher Karnofsky performance status). INTERPRETATION Results determined the psychometric properties of the updated lung cancer module, which is ready for use in international clinical studies. FUNDING EORTC Quality of Life Group.
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Affiliation(s)
- Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany.
| | - Omar Shamieh
- Department of Palliative Care, King Hussein Cancer Center, Amman, Jordan
| | - Marianne J Hjermstad
- Regional Advisory Unit for Palliative Care and European Palliative Care Research Centre, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Teresa Young
- East and North Hertfordshire NHS Trust, Mount Vernon Cancer Centre, London, UK
| | - Tara Chalk
- East and North Hertfordshire NHS Trust, Mount Vernon Cancer Centre, London, UK
| | | | | | | | - Krzysztof A Tomaszewski
- Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland
| | - Samantha Serpentini
- Veneto Institute of Oncology IOV-IRCCS Comprehensive Cancer Center, Padova, Italy
| | - Monica Pinto
- Rehabilitation Medicine Unit, Department of Supportive Care, Istituto Nazionale Tumori - IRCCS- Fondazione G Pascale, Naples, Italy
| | | | - Annelies Janssens
- Department of Thoracic Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Ofir Morag
- Chaim Sheba Medical Center, Ramat-Gan, Israel
| | - Wei-Chu Chie
- Institute of Epidemiology and Preventive Medicine and Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Juan I Arraras
- Oncology Departments, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Cecilia Pompili
- Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | | | - Marlene Hechtner
- University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Despina Katsochi
- Department of Radiation Oncology, Hygeia Hospital, Athens, Greece
| | - Karolina Müller
- Center for Clinical Studies, University Hospital Regensburg, Regensburg, Germany
| | - Laura Gräfenstein
- Department of Internal Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Christian Schulz
- Department of Internal Medicine, University Hospital Regensburg, Regensburg, Germany
| | - Andrew Bottomley
- Quality of Life Department, European Organisation for Research and Treatment of Cancer, Brussels, Belgium
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Edbrooke L, Granger CL, Clark RA, Denehy L. Physical Activity Levels Are Low in Inoperable Lung Cancer: Exploratory Analyses from a Randomised Controlled Trial. J Clin Med 2019; 8:jcm8091288. [PMID: 31450784 PMCID: PMC6780073 DOI: 10.3390/jcm8091288] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 08/15/2019] [Accepted: 08/21/2019] [Indexed: 12/30/2022] Open
Abstract
Background: In inoperable lung cancer, evidence is limited regarding physical activity (PA) and associations with other outcomes. Aims: in the usual care (UC) group of an RCT to (1) explore whether baseline PA was associated with improved follow-up outcomes, (2) identify baseline variables associated with higher follow-up PA and in all RCT participants, to (3) analyse patterns of objectively measured PA, and (4) report on characteristics of those who were able to maintain or increase PA levels. Methods: exploratory analyses of an assessor-blinded RCT. Outcomes, assessed at baseline, nine weeks and six months, included PA (seven-days of accelerometry), six-minute walk distance (6MWD), muscle strength, symptoms, mood and health-related quality of life (HRQoL). Results: 92 participants were randomised, 80 completed baseline accelerometry (39 intervention group (IG), 41 UC), characteristics: mean (SD) age 63.0 (12.3) years, 56% male, 51% stage IV disease. Baseline PA: median (IQR) steps/day 2859.6 (2034.0–3849.2) IG versus 3195.2 (2161.2–4839.0) UC. Associations between baseline PA and six-month outcomes were significant for HRQoL and 6MWD. PA at six months was significantly associated with baseline age, 6MWD and quadriceps strength. Between-group change score (steps/day) mean differences (95% CI) at nine weeks (174.5 (−1504.7 to 1853.7), p = 0.84) and six months (574.0 (−1162.3 to 2310.3), p = 0.52). Conclusions: further research is required to determine patient subgroups deriving the greatest benefits from PA interventions.
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Affiliation(s)
- Lara Edbrooke
- Department of Physiotherapy, The University of Melbourne, Melbourne VIC 3010, Australia.
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne VIC 3000, Australia.
| | - Catherine L Granger
- Department of Physiotherapy, The University of Melbourne, Melbourne VIC 3010, Australia
- Department of Physiotherapy, Royal Melbourne Hospital, Parkville VIC 3050, Australia
| | - Ross A Clark
- School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs QLD 4556, Australia
| | - Linda Denehy
- Allied Health Department, Peter MacCallum Cancer Centre, Melbourne VIC 3000, Australia
- School of Health Sciences, The University of Melbourne, Melbourne VIC 3010, Australia
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Measurement of physical activity in clinical practice and research: advances in cancer and chronic respiratory disease. Curr Opin Support Palliat Care 2019; 12:219-226. [PMID: 29979317 DOI: 10.1097/spc.0000000000000372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Physical activity has emerged as an important health outcome and its assessment, in particular with objective monitors, has proliferated in recent years. This review considers recent advances in physical activity measurement and clinical trials in cancer and chronic respiratory diseases where physical activity was a primary or key secondary outcome focusing on methodological learning points. RECENT FINDINGS There is growing data on (i) the validity of commercial 'consumer' physical activity monitors, e.g. FitBit, and (ii) the role of hybrid physical activity assessments; combining objective and subjective measures to understand physical activity quantity and quality. In both cases, adherence is challenging and can be optimized using short monitoring protocols, e.g., 3-4 days, and by providing clear instructions and support materials to participants. Studies in cancer and chronic respiratory disease have found mixed effects from physical activity interventions based on pedometers, behavior change techniques, online resources, and/or therapeutic nutrition. The most responsive physical activity outcomes and minimum clinically important differences are still to be understood. SUMMARY Physical activity measures provide an opportunity to detect changes in health behavior. However, measuring physical activity as a trial endpoint is challenging and focusing effort to ensure optimal participant compliance is important.
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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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Yarmus L, Nguyen PT, Montemayor K, Jennings M, Bade B, Shafiq M, Silvestri G, Steinfort D. Year in review 2017: Interventional pulmonology, lung cancer, pleural disease and respiratory infections. Respirology 2018; 23:628-635. [PMID: 29641840 DOI: 10.1111/resp.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 03/21/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Lonny Yarmus
- Division of Pulmonary and Critical Care, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Phan T Nguyen
- The University of Adelaide, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Kristina Montemayor
- Division of Pulmonary and Critical Care, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mark Jennings
- Division of Pulmonary and Critical Care, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brett Bade
- Division of Pulmonary and Critical Care Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Majid Shafiq
- Division of Pulmonary and Critical Care, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Gerard Silvestri
- Division of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Daniel Steinfort
- Department of Respiratory Medicine, Royal Melbourne Hospital, VIC, Australia
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Associations of objectively assessed physical activity and sedentary time with health-related quality of life among lung cancer survivors: A quantile regression approach. Lung Cancer 2018; 119:78-84. [PMID: 29656757 DOI: 10.1016/j.lungcan.2018.03.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/05/2018] [Accepted: 03/09/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVES No studies have examined objectively assessed physical activity, sedentary time, and patient-reported outcomes among lung cancer survivors. The objective of this study was to determine associations of objectively assessed moderate-to-vigorous intensity physical activity (MVPA) and sedentary time with health-related quality of life (HRQoL) and fatigue among lung cancer survivors. MATERIALS AND METHOD Lung cancer survivors in Southern Alberta (N = 540) were invited to complete a mailed survey that assessed HRQoL [Functional Assessment of Cancer Therapy-Lung (FACT-L)], physical and functional well-being [Trial Outcome Index (TOI)], and fatigue [Fatigue Scale (FS)]. Physical activity and sedentary time data was collected using an Actigraph® GT3X+ accelerometer that was worn on the hip for seven consecutive days. Quantile regression was used to examine associations of HRQoL and fatigue with physical activity and sedentary time at the 25th, 50th, and 75th HRQoL and fatigue percentiles. RESULTS A total of 127 lung cancer survivors participated for a 24% response rate (Mean age = 71 years; Mean time since diagnosis = 75 months). Total MVPA minutes was positively associated with fewer fatigue symptoms at the 25th percentile (β = 0.16, p = 0.046). Total sedentary time was inversely associated with HRQoL at the 75th percentile (β = -0.07, p = 0.014) and inversely associated with fatigue symptoms at the 50th percentile (β = -0.04, p = 0.009). Total sedentary time was also inversely associated with physical and functional well-being scores at the 25th (β = -0.07, p = 0.045), 50th (β = -0.07, p = 0.004) and 75th (β = -0.04, p = 0.035) percentiles. CONCLUSION Across the HRQoL, fatigue, and physical and functional well-being distributions, sedentary time was inversely associated with HRQoL, fatigue, and physical and functional well-being in lung cancer survivors. Small associations were observed between MVPA and fatigue, but no associations emerged with HRQoL or physical and functional well-being.
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