Preoperative exercise training prevents functional decline after lung resection surgery: a randomized, single-blind controlled trial Short-term preoperative exercise therapy does not improve long-term outcome after lung cancer surgery: a randomized controlled study† Pulmonary function and physical performance outcomes with preoperative physical therapy in upper abdominal surgery: a randomized controlled trial A modified exercise protocol may promote continuance of exercise after the intervention in lung cancer patients—a pragmatic uncontrolled trial The effects of preoperative short-term intense physical therapy in lung cancer patients: a randomized controlled trial. Preoperative pulmonary rehabilitation in patients undergoing lung resection for non-small cell lung cancer. Safety and Feasibility of an Exercise Intervention for Patients Following Lung Resection High-intensity training and cardiopulmonary exercise testing in patients with chronic obstructive pulmonary disease and non-small-cell lung cancer undergoing lobectomy. Pulmonary rehabilitation programme for patients undergoing curative lung cancer surgery. Short and long-term effects of supervised versus unsupervised exercise training on health-related quality of life and functional outcomes following lung cancer surgery - a randomized controlled trial. Cardiopulmonary exercise tests and lung cancer surgical outcome. Effects of an early postoperative walking exercise programme on health status in lung cancer patients recovering from lung lobectomy. Effects of a supervised exercise intervention on recovery from treatment regimens in breast cancer survivors. Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial. Perioperative Rehabilitation in Operable Lung Cancer Patients (PROLUCA) High-intensity training following lung cancer surgery: a randomised controlled trial Perioperative rehabilitation and physiotherapy for lung cancer patients with chronic obstructive pulmonary disease.
Objectives : To investigate the effects of a preoperative pulmonary rehabilitation programme in patients with lung cancer undergoing video-assisted thoracic surgery .  Design : R and omized , single-blind controlled trial . Setting : Teaching hospital . Subjects : Patients with suspected or confirmed lung cancer undergoing video-assisted thoracic surgery .  Intervention : Participants were r and omized  to either a prehabilitation group or a control group .  Participants in the prehabilitation group underwent a combination of moderate endurance and resistance training plus breathing exercises three to five times per week . Main measures : The primary outcome of the study was exercise capacity . Secondary outcomes were muscle strength ( Senior Fitness Test ) , health-related quality of life ( Short-Form 36 ) and the postoperative outcomes . Patients were evaluated at baseline ( before r and omization ) , presurgery ( only the prehabilitation group ) , after surgery and three months post-operatively . Results : A total of 40 patients were r and omized and 22 finished the study ( 10 in the prehabilitation group and 12 in the control group ) . Three patients were lost to follow-up at three months . After the training , there was a statistically significant improvement in exercise tolerance ( + 397 seconds , p = 0.0001 ) , the physical summary component of the SF-36 ( + 4.4 points , p = 0.008 ) and muscle strength ( p < 0.01 ) . There were no significant differences between groups after surgery . However , three months postoperatively , significant differences were found in the mean change of exercise capacity ( p = 0.005 ) , physical summary component ( p = 0.001 ) and upper and lower body strength ( p = 0.045 and p = 0.002 ) . Conclusions : A pulmonary rehabilitation programme before video-assisted thoracic surgery seems to improve patients ’ preoperative condition and may prevent functional decline after surgery . Clinical Registration Number : NCT01963923 ( Registration date 10/10/2013 OBJECTIVES Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer . This r and omized trial evaluates the impact of adding rehabilitation ( Rehab ) with high-intensity interval training ( HIIT ) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome . METHODS Patients with operable lung cancer were r and omly assigned to  usual care ( UC , n = 77 ) or to intervention group ( Rehab  , n = 74 ) that entailed HIIT that was implemented only preoperatively .  Cardiopulmonary exercise testing ( CPET ) and pulmonary functional tests ( PFTs ) including forced vital capacity ( FVC ) , forced expiratory volume ( FEV 1 ) and carbon monoxide transfer factor ( KCO ) were performed before and 1 year after surgery . RESULTS During the preoperative waiting time ( median 25 days ) , Rehab patients participated to a median of 8 HIIT sessions ( interquartile [ IQ ] 25 - 75 % , 7 - 10 ) . At 1 year follow-up , 91 % UC patients and 93 % Rehab patients were still alive ( P = 0.506 ) . Pulmonary functional changes were non-significant and comparable in both groups ( FEV 1 mean -7.5 % , 95 % CI , -3.6 to -12.9 and in KCO mean 5.8 % 95 % CI 0.8 - 11.8 ) Compared with preoperative CPET results , both groups demonstrated similar reduction in peak oxygen uptake ( mean -12.2 % 95 % CI -4.8 to -18.2 ) and in peak work rate ( mean -11.1 % 95 % CI -4.2 to -17.4 ) . CONCLUSIONS Short-term preoperative rehabilitation with HIIT does not improve pulmonary function and aerobic capacity measured at 1 year after lung cancer resection . TRIAL REGISTRY Clinical Trials.gov ; No. NCT01258478 ; www . clinical trials.gov Objective : Investigation of the effects of preoperative physical therapy on pulmonary function and physical performance before and after upper abdominal surgery . Design : Non-blind r and omized controlled trial . Setting : Tertiary public hospital and private university , São Paulo state , Brazil . Subjects : Thirty-two patients undergoing abdominal surgery . Interventions : Patients were r and omly assigned to receive physical therapy , with respiratory and global exercises , 2–3 weeks before surgery ( treatment group ; n = 16 ) or await operation without engaging in practicing ( control group ; n = 16 ) . After surgery , a physical therapy protocol was administered to all subjects until the seventh postoperative day . Main measures : Pulmonary function outcome variables were inspiratory and expiratory strength , respiratory muscle endurance and spirometry , and physical performance outcome variables were the functional independence measure and 6-minute walk test distance . Any postoperative pulmonary complications were recorded . Results : There were no between-group differences at r and omization . In the preoperative period , patients in the intervention group had higher inspiratory strength and respiratory muscle endurance than controls ( 88 cmH2O versus 64 cmH2O and 28 cmH2O versus 23 cmH2O , respectively ; P < 0 0.05 ) . On the seventh postoperative day , in addition to inspiratory force and respiratory muscle endurance , the intervention group showed better results than controls in the functional independence measure score ( 118 versus 95 ) and 6-minute walk test distance ( 368.5 m versus 223 m ) , all P < 0 0.05 . Postoperative pulmonary complications occurred in 11 patients in the control group and five in the intervention group ( P = 0.03 ) . Conclusion : Preoperative physical therapy improved pulmonary function and physical performance in the pre- and postoperative periods among patients undergoing upper abdominal surgery Purpose A previous study investigated the effects of a well-documented COPD exercise protocol in lung cancer patients . The study showed improvements in physical fitness , but poor adherence to continued exercise after intervention . The aim of the present study was to investigate the effect of a modified exercise intervention on post-intervention adherence , and physical fitness in a broad group of lung cancer patients . Methods Fifty-nine patients enrolled in a 9-week exercise program . Eligibility criteria were limited to presence of motivation , and absence of comorbidities that could jeopardize safety . The intervention included three times 3 weeks of exercise ( 3 weeks supervised , 3 weeks home-based and 3 weeks supervised ) . The patient ’s activities were structured by logbooks during the 3 weeks at home . VO2 max was estimated at baseline and at the end of intervention . Self-reported quality of life was recorded before and after the exercise program . Post-intervention exercise activity was assessed by telephone interviews 4 weeks after intervention . Results Fifty-one patients initiated the exercise intervention and 29 patients successfully completed the exercise program .  Full data were available for 25 patients regarding estimated VO2 max . Twenty-six of the 29 were available for follow-up with respect to continuance of physical activity . Among the 26 who completed the 9-week training program , 18 ( 69 % ) continued to be physically active on a daily basis . No change in estimated VO2 max was observed . A trend towards increased quality of life and better symptom control was noted . Conclusions The present study showed an increased level of continuance of physical activity compared to the previous study . The present study could , however , not repeat the significant improvements in estimated VO2 max from the previous study BACKGROUND We planned to investigate the effect of preoperative short period intensive physical therapy on lung functions , gas-exchange , and capacity of diffusion , and ventilation-perfusion distribution of patients with non-small cell lung cancer . METHODS Sixty patients with lung cancer , who were deemed operable , were r and omly allocated into two groups . Intensive physical therapy was performed in patients in the study group before operation . Both groups received routine physical therapy after operation . RESULTS There was no difference in pulmonary function tests between the two groups . Intensive physical therapy statistically significantly increased peripheral blood oxygen saturation . At least one complication was noted in 5 patients ( 16.7 % ) in the control group , and 2 ( 6.7 % ) , in the study group . However , there was no statistically significant difference ( p = 0,4 ) . The hospital stay has been found to be statistically significantly shortened by intensive physical therapy ( p < 0.001 ) . Ventilation-perfusion distribution was found to be significantly effected by intensive physical therapy . The change was prominent in the the contralateral lung ( p < 0.001 ) . CONCLUSIONS Intensive physical therapy appeared to increase oxygen saturation , reduce hospital stay , and change the ventilation/perfusion distribution . It had a significant , positive effect on the exercise capacity of patients BACKGROUND The impact of short-term preoperative pulmonary rehabilitation on exercise capacity of patients with chronic obstructive pulmonary disease undergoing lobectomy for non-small cell lung cancer is evaluated . METHODS A prospect i ve observational study was design ed . Inclusion criteria consisted of an indication to lung resection because of a clinical stage I or II non-small cell lung cancer and a chronic obstructive disease on preoperative pulmonary function test . In such conditions , maximal oxygen consumption by a cardio-pulmonary exercise test was evaluated ; when this result ed as being < or = 15 ml/kg/min a pulmonary rehabilitation programme lasting 4 weeks was considered . Twelve patients fulfilled inclusion criteria , completed the preoperative rehabilitation programme and underwent a new functional evaluation prior to surgery . The postoperative record of these patients was collected . RESULTS On completion of pulmonary rehabilitation , the resting pulmonary function test and diffuse lung capacity of patients was unchanged , whereas the exercise performance was found to have significantly improved ; the mean increase in maximal oxygen consumption proved to be at 2.8 ml/kg/min ( p<0.01 ) . Eleven patients underwent lobectomy ; no postoperative mortality was noted and mean hospital stay was 17 days . Postoperative pulmonary complication was recorded in 8 patients . CONCLUSIONS Short-term preoperative pulmonary rehabilitation could improve the exercise capacity of patients with chronic obstructive pulmonary disease who are c and i date s for lung resection for non-small cell lung cancer Purpose . Following surgical lung resection , patients frequently suffer functional decline and reduced activity levels . Despite this exercise interventions are not routinely provided . This study aim ed to establish the safety and feasibility of exercise administered following lung resection in an Australian setting . Method . Pilot r and omized controlled trial . Fifteen individuals ( 53 % male ) , mean ± st and ard deviation age 65.5 ± 16.1 years , undergoing surgery for suspected lung cancer . R and omization occurred postoperatively . Control arm received protocol ized inpatient respiratory physiotherapy . Intervention arm additionally received twice daily exercise until discharge home and twice weekly as outpatient for 8 weeks . Outcome measures ( safety , feasibility , functional capacity , functional mobility , and health-related quality of life [ HRQoL ] ) were assessed preoperatively and 2 and 12 weeks postoperatively . Results . Fifteen participants ( lung cancer n = 10 ) were assigned to control ( n = 8) and intervention ( n = 7 ) groups . Inpatient exercise was delivered on 71 % of occasions ( 35 out of 49 planned sessions ) . Four participants attended outpatient exercise sessions and these participants attended sessions on 81 % of occasions ( 52 out of 64 planned sessions ) . No adverse events occurred . There was a significant between group difference in 6-Minute Walk Test ( 6MWT ; P = .024 ) . In both groups the 6MWT declined from baseline to 2 weeks postoperative and then improved up to 12 weeks ; improvements were greater in the intervention group . Intervention was associated with positive trends of improvement in some HRQoL domains . Conclusions . Exercise intervention performed in the inpatient and outpatient setting s for individuals following lung resection  was safe and feasible . The uptake rate for outpatient exercise was 57 % , similar to previous trials ; however , adherence was excellent within the subgroup of participants who attended . Further research is required to investigate the best setting of exercise delivery and explore ways to improve the uptake rate OBJECTIVES Peak VO2 , as measure of physical performance is central to a correct preoperative evaluation in patients with both non-small-cell lung cancer ( NSCLC ) and chronic obstructive pulmonary disease ( COPD ) because it is closely related both to operability criteria and the rate of postoperative complications . Strategies to improve peak VO2 , as a preoperative pulmonary rehabilitation programme ( PRP ) , should be considered favourably in these patients . In order to clarify the role of pulmonary rehabilitation , we have evaluated the effects of 3-week preoperative high-intensity training on physical performance and respiratory function in a group of patients with both NSCLC and COPD who underwent lobectomy . METHODS We studied 40 patients with both NSCLC and COPD , age < 75 years , TNM stages I-II , who underwent lobectomy . Patients were r and omly divided into two groups ( R and S ) : Group R underwent an intensive preoperative PRP , while Group S underwent only lobectomy . We evaluated peak VO2 in all patients at Time 0 ( T0 ) , after PRP/before surgery in Group R/S ( T1 ) and 60 days after surgery , respectively , in both groups ( T2 ) . RESULTS There was no difference between groups in peak VO2 at T0 , while a significant difference was observed both at T1 and T2 . In Group R , peak VO2 improves significantly from T0 to T1 : 14.9 ± 2.3 - 17.8 ± 2.1 ml/kg/min ± st and ard deviation ( SD ) , P < 0.001 ( 64.5 ± 16.5 - 76.1 ± 14.9 % predicted ± SD , P < 0.05 ) and deteriorates from T1 to T2 : 17.8 ± 2.1 - 15.1 ± 2.4 , P < 0.001 ( 76.1 ± 14.9 - 64.6 ± 15.5 , P < 0.05 ) , reverting to a similar value to that at T0 , while in Group S peak VO2 did not change from T0 to T1 and significantly deteriorates from T1 to T2 : 14.5 ± 1.2 - 11.4 ± 1.2 ml/kg/min ± SD , P < 0.00001 ( 60.6 ± 8.4 - 47.4 ± 6.9 % predicted ± SD , P < 0.00001 ) . CONCLUSIONS PRP was a valid preoperative strategy to improve physical performance in patients with  both NSCLC and COPD and this advantage was also maintained after surgery OBJECTIVES The aim of the study was to develop a multistr and ed pragmatic rehabilitation programme for operable lung cancer patients , that looks into feasibility , process indicators , outcome measures , local adaptability , compliance and potential cost benefit . METHODS An outpatient-based complex intervention , rehabilitation for operated lung cancer ( ROC ) programme , was developed to optimize physical status , prepare for the inpatient journey and support through recovery after surgery . It includes exercise classes , smoking cessation , dietary advice and patient education and was tested in an enriched cohort study within a regional thoracic unit over 18 months . RESULTS A multistr and ed pragmatic rehabilitation programme pre- and post-surgery is feasible . Fifty-eight patients received the intervention and 305 received st and ard care . Both groups were matched for age , lung function comorbidity and type of surgery . Patients in the intervention group attended exercise classes twice a week until surgery , which was not delayed . Patients attended four sessions presurgery ( range 1 - 15 ) , result ing in an improvement of 20 m ( range -73 - 195 , P = 0.001 ) in a 6-min walk test and 0.66 l in forced expiratory volume in 1 s ( range -1.85 from 1.11 , P = 0.009 ) from baseline to presurgery . Fifty-four percentage of smokers in the intervention group stopped smoking . Sixteen percentage of patients were identified as being at risk of malnourishment and received nutritional intervention . There was a trend in patients in the intervention group towards experiencing fewer postoperative pulmonary complications than those in the non-intervention group ( 9 vs 16 % , respectively , P = 0.21 ) and fewer readmissions to hospital because of complications ( 5 vs 14 % respectively , P = 0.12 ) . CONCLUSION Chronic obstructive pulmonary disease-type pulmonary rehabilitation before and after lung cancer surgery is viable , and preliminary results suggest improvement in physical measures . A multicentre , r and omized controlled trial is warranted to confirm clinical efficacy . IS RCT N REGISTRATION NUMBER IS RCT N00061628 OBJECTIVE Surgical resection enhances long-term survival after lung cancer , but survivors face functional deficits and report on poor quality of life long time after surgery . This study evaluated short and long-term effects of supervised group exercise training on health-related quality of life and physical performance in patients , who were radically operated for lung cancer . METHODS A r and omized , assessor-blinded , controlled trial was performed on 78 patients undergoing lung cancer surgery . The intervention group ( IG , n=41 ) participated in supervised out-patient exercise training sessions , one hour once a week for ten weeks . The sessions were based on aerobic exercises with target intensity of 60 - 80 % of work capacity , resistance training and dyspnoea management . The control group ( CG , n=37 ) received one individual instruction in exercise training . Measurements consisted of : health-related quality of life ( SF36 ) , six minute walk test ( 6MWT ) and lung function ( spirometry ) , assessed three weeks after surgery and after four and twelve months . RESULTS Both groups were comparable at baseline on demographic characteristic and outcome values . We found a statistically significant effect after four months in the bodily pain domain of SF36 , with an estimated mean difference ( EMD ) of 15.3 ( 95 % CI:4 to 26.6 , p=0.01 ) and a trend in favour of the intervention for role physical functioning ( EMD 12.04 , 95 % CI : -1 to 25.1 , p=0.07 ) and physical component summary ( EMD 3.76 , 95 % CI:-0.1 to 7.6 , p=0.06 ) . At 12 months , the tendency was reversed , with the CG presenting overall slightly better measures . We found no effect of the intervention on 6MWT or lung volumes at any time-point . CONCLUSION Supervised compared to unsupervised exercise training result ed in no improvement in health-related quality of life , except for the bodily pain domain , four months after lung cancer surgery . No effects of the intervention were found for any outcome after one year STUDY OBJECTIVES Surgical resection remains the treatment of choice for anatomically resectable non-small cell lung cancer . However , the presence of associated comorbid conditions increases the risk of death and surgical complications . Several studies have evaluated the usefulness of preoperative exercise testing for predicting postoperative morbidity and mortality . The aim of this study was to establish whether exercise testing could predict poor surgical outcome in lung cancer surgery and whether the absolute value or percentage of predicted value is the better predictor of the surgical outcome . DESIGN The study was design ed as a prospect i ve study . PATIENTS AND SETTING One hundred thirty patients with potentially operable lung cancer at Papworth Hospital over 2 years were recruited ; of these , 101 underwent curative surgery .  INTERVENTIONS Spirometry and cardiopulmonary exercise tests were performed for every patient ( n = 99 ) , except for two patients with back problems . We also recorded the outcome of surgery , in particular , complications and mortality . MEASUREMENTS AND RESULTS Mean maximum oxygen transport at peak exercise ( Vo(2)peak ) was 18.3 mL/kg/min ( SD , 4.7 mL/kg/min ) , and mean percentage of predicted Vo(2)peak value was 84.4 % ( SD , 30 % ) . Poor surgical outcome was significantly related to Vo(2)peak percentage of predicted ( p < 0.01 ) but not to the actual oxygen uptake value . CONCLUSIONS The use of the percentage of predicted Vo(2)peak value would be a better indicator of surgical outcome , since it predicts the surgical outcome better , and corrects for normal physiologic ranges . The threshold of Vo(2)peak for surgical intervention could be set between 50 % and 60 % of predicted without excess surgical mortality AIMS AND OBJECTIVES To examine the effects of an early postoperative walking exercise programme on postlobectomy lung cancer patients . BACKGROUND Few interventional studies on the postoperative health status of lung cancer patients have considered the efficacy of programmes design ed to improve critical health variables . DESIGN A two-group quasi-experimental , longitudinal approach repeated four times examined participant data collected 12 - 18 hours prior to surgery and again at one , three and six months after surgery . METHODS We assigned the first 33 enrolled participants to the intervention group and the second 33 to the control group . The intervention was a daily supervised walking exercise programme consisting of 12 weeks of brisk walking exercise that began on the day following transfer to the regular ward along with weekly telephone calls until 12 weeks after discharge . Health status was measured using a structured question naire ( World Health Organization Quality of Life , brief version ) and clinical tests ( pulmonary function test and 6-minute walk test ) . We analysed data using general estimating equations , with p < 0·05 considered significant . RESULTS Intervention group pulmonary and physical functions were increasingly better over time than those of the control group , with no significant difference in quality of life between the two groups . Compared to the control group , the intervention group earned significantly better values for FVC% at postoperative month 3 and for FEV1 % at postoperative months 3 and 6 . Intervention group 6MWT scores were significantly better than those of the control group at postoperative months 1 , 3 and 6 . CONCLUSION This study demonstrated the benefits of an early postoperative walking exercise intervention for pulmonary and physical function in postlobectomy lung cancer patients . RELEVANCE TO CLINICAL PRACTICE The results may guide the design of appropriate interventions in the future . Clinical trials in other population s are needed to confirm the results of this study PURPOSE / OBJECTIVES To investigate the effects of supervised exercise training on cardiopulmonary function and fatigue in cancer survivors undergoing various clinical treatments . DESIGN Pretest and post-test quasiexperimental . SETTING Outpatient oncology rehabilitation center . SAMPLE 96 breast cancer survivors undergoing various clinical treatments . METHODS Subjects were divided into four groups based on the specific type of clinical treatment : surgery alone ( n = 22 ) ; surgery and chemotherapy ( n = 30 ) ; surgery and radiation ( n = 17 ) ; and surgery , chemotherapy , and radiation ( n = 27 ) . Following a comprehensive screening and medical examination , cardiovascular endurance , pulmonary function , and fatigue were assessed , leading to the development of an individualized exercise prescription and a six-month exercise intervention . Repeated- measures analysis of variance and covariance were used to compare the effectiveness of the intervention and differences among treatment groups . MAIN RESEARCH VARIABLES Systolic and diastolic blood pressure , resting heart rate , forced vital capacity , forced expiratory volume , predicted oxygen consumption , time on treadmill , and fatigue . FINDINGS Cardiopulmonary function ( predicted maximal oxygen consumption and time on treadmill ) significantly increased in all groups after exercise training . In addition , resting heart rate and forced vital capacity significantly improved in those receiving surgery , chemotherapy , and radiation . Psychologically , the exercise intervention result ed in significant reductions in behavioral , affective , sensory , cognitive and mood , and total fatigue scale scores in all three groups who received treatment with surgery . The breast cancer survivors in the surgery-alone group showed significant reductions in behavioral , affective , and total fatigue scale scores but not in sensory and cognitive and mood fatigue scale scores . CONCLUSIONS The results suggest that moderate intensity , individualized , prescriptive exercise maintains or improves cardiopulmonary function with concomitant reductions in fatigue regardless of treatment type . Moreover , cancer survivors receiving combination chemotherapy and radiotherapy following surgery appear to benefit to a greater extent as a result of an individualized exercise intervention . IMPLICATION S FOR NURSING Clinicians need to be aware of adjuvant therapies such as moderate exercise that attenuate negative side effects of cancer treatments . Symptom management recommendations should be given to cancer survivors concerning the effectiveness of exercise throughout the cancer continuum and the importance of participating in a cancer rehabilitation exercise program OBJECTIVE To evaluate the effect of a combined hospital plus home exercise programme following curative surgery for non-small cell lung cancer ( NSCLC ) . DESIGN R and omised controlled trial . SETTING Teaching hospital . PARTICIPANTS One hundred and thirty-one subjects with NSCLC admitted for curative surgery . INTERVENTIONS Participants were r and omised to usual care or a hospital plus home exercise programme . OUTCOMES The primary outcome was the between-group difference in physical activity 4 weeks after surgery . Secondary outcomes were the difference in quadriceps strength , exercise tolerance and quality of life [ Short Form-36 ( SF-36 ) and European Organisation for Research and Treatment of Cancer ( EORTC ) QLQ-LC13 ] from pre-operatively ( baseline ) to 4 weeks after surgery . RESULTS The participants ( n=131 ) had a mean age of 68 [ st and ard deviation ( SD ) 11 ] years and mean forced expiratory volume in 1 second of 2.4 ( SD 1.1)l . There were no significant differences in physical activity between the groups 4 weeks after surgery [ mean difference adjusted for baseline 12minutes/day , 95 % confidence interval ( CI ) -20.2 to 44.1 ] . In addition , there were no significant differences in total SF-36 or EORTC QLQ-LC13 scores from baseline to 4 weeks after surgery . Both groups had recovered their pre-operative walking distance 4 weeks after surgery , and there were no differences between the groups ( mean difference in Incremental Shuttle Walk Test from baseline to 4 weeks after surgery ( -26 m , 95 % CI -94.2 to 42.3 ) . CONCLUSIONS A hospital plus home exercise programme showed little benefit in unselected patients with NSCLC following surgery . Regardless of group allocation , the patients had recovered their pre-operative exercise tolerance levels by 4 weeks after surgery Introduction . Surgical resection in patients with non – small cell lung cancer ( NSCLC ) may be associated with significant morbidity , functional limitations , and decreased quality of life . Objectives . The safety and feasibility of a preoperative and early postoperative rehabilitation program in patients operated for NSCLC was determined in a nonhospital setting , with focus on high-intensity interval exercise . Methods . Forty patients with biopsy-proven NSCLC stages I to IIIa referred for surgical resection at the Department of Cardiothoracic Surgery RT , Rigshospitalet , University of Copenhagen , were r and omly assigned to 1 of 4 groups ( 3 intervention groups and 1 control group ) . The preoperative intervention consisted of a home-based exercise program , while the postoperative exercise program comprised a supervised group exercise program involving resistance and high-intensity interval cardiorespiratory exercise 2 hours weekly for 12 weeks combined with individual counseling . The study endpoints were inclusion rate , adherence , and number of adverse events . Results . Forty patients ( of 124 screened ; 32 % ) were included and r and omized into the 4 groups . The postoperative exercise was completed by 73 % of the patients r and omized to this intervention . No adverse events were observed , indicating that the early postoperative exercise program is safe . The preoperative home-based exercise program was not feasible due to interfering diagnostic procedures and fast-track surgery that left only 1 to 2 weeks between diagnosis and surgery . Conclusion . The early postoperative exercise program for patients with NSCLC was safe and feasible , but in a fast-track set up , a preoperative home-based exercise program was not feasible for this population Background Many patients with lung cancer are deconditioned with poor physical fitness . Lung resection reduces physical fitness further , impairing the patient 's ability to function in daily life . Methods We conducted a single-blind r and omised controlled trial of high-intensity endurance and strength training ( 60 min , three times a week , 20 weeks ) , starting 5–7 weeks after surgery . The control group received st and ard postoperative care . The primary outcome was the change in peak oxygen uptake measured directly during walking until exhaustion . Other outcomes included changes in pulmonary function , muscular strength by one-repetition maximum ( 1RM ) , total muscle mass measured by dual energy X-ray absorptiometry , daily physical functioning and quality of life ( QoL ) . Results The intention-to-treat analysis of the 61 r and omised patients showed that the exercise group had a greater increase in peak oxygen uptake ( 3.4 mL/kg/min between-group difference , p=0.002 ) , carbon monoxide transfer factor ( Tlco ) ( 5.2 % predicted , p=0.007 ) , 1RM leg press ( 29.5 kg , p<0.001 ) , chair st and ( 2.1 times p<0.001 ) , stair run ( 4.3 steps , p=0.002 ) and total muscle mass ( 1.36 kg , p=0.012 ) compared with the controls . The mean±SD QoL ( SF-36 ) physical component summary score was 51.8±5.5 and 43.3±11.3 ( p=0.006 ) , and the mental component summary score was 55.5±5.3 and 46.6±14.0 ( p=0.015 ) in the exercise and control groups , respectively . Conclusions In patients recently operated for lung cancer , high-intensity endurance and strength training was well tolerated and induced clinical ly significant improvements in peak oxygen uptake , Tlco , muscular strength , total muscle mass , functional fitness and QoL. This study may provide a basis for exercise therapy after lung cancer surgery . Trial registration number NCT01748981 OBJECTIVE The purpose of this study was to investigate the impact of pulmonary rehabilitation on surgical morbidity and lung function in lung cancer patients with chronic obstructive pulmonary disease ( COPD ) . METHODS Prospect ively , 22 lung cancer patients with COPD who underwent lobectomy between 2000 and 2003 were enrolled for this study as a rehabilitation group (  Rehab . Group ) . The criteria of COPD were preoperative forced expiratory volume in 1 second (FEV1)/forced vital capacity ( FVC ) < or = 70 % and more than 50 % of low attenuation area in a computed tomography . Preoperatively patients performed aggressive pulmonary exercise for two weeks and received chest physiotherapy postoperatively .  As a historical control , 60 patients with lung cancer who fulfilled the same criteria but did not receive rehabilitation between 1995 and 1999 ( control group ) were entered in this study . RESULTS Patient background s were all equivalent between the two groups . However , FEV1 and FEV1/FVC were significantly lower in the Rehab . Group ( p < 0.05 ) . Prolonged oxygen supplement and tracheostomy tended to be more frequent in the control group . The ratio of actual postoperative to predicted postoperative FEV1 was significantly better in the Rehab . Group ( p = 0.047 ) . Furthermore , postoperative hospital stay was significantly longer in the control group ( p = 0.0003 ) . CONCLUSION Despite lower FEV1 and FEV1/FVC in the Rehab . Group , postoperative pulmonary complications and long hospital stay could be effectively prevented and FEV1 was well preserved by rehabilitation and physiotherapy
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 .
Rehabilitation exercise strengthens muscle capacity , but does not improve impaired pulmonary function , which emphasizes the possible mechanism of the protocol design
Objectives This meta- analysis aim ed 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 .