Effect of Exercise Interventions on Quality of Life in Patients With Lung Cancer: A Systematic Review of Randomized Controlled Trials

[Respiratory physiotherapy in private practice: Interest and prescription modalities]

INTRODUCTION

Respiratory diseases represent a major public health issue and impact both quality of life and life expectancy of the patients.

STATE OF ART

Several interventions used in respiratory physiotherapy have been shown to reduce dyspnoea, improve quality of life and reduce hospitalisation in many respiratory diseases. However, respiratory physiotherapy remains poorly known to the medical community and may be under-prescribed.

PERSPECTIVES

In order to improve the interdisciplinarity around the patient with respiratory impairment, we describe the interests and prescription modalities of liberal respiratory physiotherapy. In the context of respiratory physiotherapy acts, the precision of drafting prescription directly conditions the means implemented by the physiotherapist regarding care provided to the patient.

CONCLUSION

The increased knowledge of prescribers, both concerning the prescription methods and the precise content of the rehabilitation sessions is one of the keys to their success.

Exercise across the Lung Cancer Care Continuum: An Overview of Systematic Reviews

BACKGROUND

Growing evidence supports exercise for people with lung cancer. This overview aimed to summarise exercise intervention efficacy and safety across the care continuum.

METHODS

Eight databases (including Cochrane and Medline) were searched (inception-February 2022) for systematic reviews of RCTs/quasi-RCTs. Eligibility: population-adults with lung cancer; intervention: exercise (e.g., aerobic, resistance) +/- non-exercise (e.g., nutrition); comparator: usual care/non-exercise; primary outcomes: exercise capacity, physical function, health-related quality of life (HRQoL) and post-operative complications. Duplicate, independent title/abstract and full-text screening, data extraction and quality ratings (AMSTAR-2) were completed.

RESULTS

Thirty systematic reviews involving between 157 and 2109 participants (n = 6440 total) were included. Most reviews (n = 28) involved surgical participants. Twenty-five reviews performed meta-analyses. The review quality was commonly rated critically low (n = 22) or low (n = 7). Reviews commonly included combinations of aerobic, resistance and/or respiratory exercise interventions. Pre-operative meta-analyses demonstrated that exercise reduces post-operative complications (n = 4/7) and improves exercise capacity (n = 6/6), whilst HRQoL findings were non-significant (n = 3/3). Post-operative meta-analyses reported significant improvements in exercise capacity (n = 2/3) and muscle strength (n = 1/1) and non-significant HRQoL changes (n = 8/10). Interventions delivered to mixed surgical and non-surgical populations improved exercise capacity (n = 3/4), muscle strength (n = 2/2) and HRQoL (n = 3). Meta-analyses of interventions in non-surgical populations demonstrated inconsistent findings. Adverse event rates were low, however, few reviews reported on safety.

CONCLUSIONS

A large body of evidence supports lung cancer exercise interventions to reduce complications and improve exercise capacity in pre- and post-operative populations. Additional higher-quality research is needed, particularly in the non-surgical population, including subgroup analyses of exercise type and setting.

Lung Cancer-Related Dyspnea: The Effects of a Handheld Fan on Management of Symptoms

BACKGROUND

The application of a handheld fan may reduce patients' shortness of breath and increase their activity tolerance by enabling cooling and air flow into the second and third branches of the trigeminal nerve.

OBJECTIVES

The aim of the study was to assess the effects of directing a handheld fan toward the face in the management of lung cancer-related dyspnea.

METHODS

Using a randomized controlled experimental design, 96 inpatients with lung cancer were evaluated, with the experimental group (n = 49) using a handheld fan to manage dyspnea for 14 days. Dyspnea, respiration rate, oxygen saturation, heart rate, and quality of life were assessed for both groups.

FINDINGS

A statistically significant difference was found in dyspnea scores between groups on the first, seventh, and fourteenth days of fan application, and statistically significant differences were found between groups in dyspnea scores, respiration rates, oxygen saturation, heart rate, and quality of life on the fourteenth day of application.