Two-Week Multimodal Prehabilitation Program Improves Perioperative Functional Capability in Patients Undergoing Thoracoscopic Lobectomy for Lung Cancer: A Randomized Controlled Trial

Autor: Yushang Cui, Shanqing Li, Tian Qiu, Zijia Liu, Lijian Pei, Li Xu, Yuguang Huang, Yuelun Zhang, Naixin Liang, Wei Chen
Rok vydání: 2019
Předmět:
Counseling
Male
Vital capacity
medicine.medical_specialty
Lung Neoplasms
Time Factors
Health Status
Prehabilitation
VATS lobectomy
Nutritional Status
Home Care Services
Hospital-Based
Relaxation Therapy
Breathing Exercises
Preoperative care
law.invention
03 medical and health sciences
FEV1/FVC ratio
Postoperative Complications
0302 clinical medicine
Randomized controlled trial
030202 anesthesiology
law
Carcinoma
Non-Small-Cell Lung
Preoperative Care
medicine
Humans
Single-Blind Method
Pneumonectomy
Lung cancer
Aged
Exercise Tolerance
Thoracic Surgery
Video-Assisted
business.industry
Resistance Training
Recovery of Function
Perioperative
Middle Aged
medicine.disease
Surgery
Editorial Commentary
Treatment Outcome
Whey Proteins
Anesthesiology and Pain Medicine
Cardiorespiratory Fitness
Beijing
Dietary Supplements
Female
business
030217 neurology & neurosurgery
Zdroj: J Thorac Dis
ISSN: 0003-2999
Popis: BACKGROUND Patients with lung cancer often experience reduced functional capacity and quality of life after surgery. The current study investigated the impact of a short-term, home-based, multimodal prehabilitation program on perioperative functional capacity in patients undergoing video-assisted thoracoscopic surgery (VATS) lobectomy for nonsmall cell lung cancer (NSCLC). METHODS A randomized controlled trial was conducted with 73 patients. Patients in the prehabilitation group (n = 37) received a 2-week multimodal intervention program before surgery, including aerobic and resistance exercises, respiratory training, nutrition counseling with whey protein supplementation, and psychological guidance. Patients in the control group (n = 36) received the usual clinical care. The assessors were blinded to the patient allocation. The primary outcome was perioperative functional capacity measured as the 6-minute walk distance (6MWD), which was assessed at 1 day before and 30 days after surgery. A linear mixed-effects model was built to analyze the perioperative 6MWD. Other outcomes included lung function, disability and psychometric evaluations, length of stay (LOS), short-term recovery quality, postoperative complications, and mortality. RESULTS The median duration of prehabilitation was 15 days. The average 6MWD was 60.9 m higher perioperatively in the prehabilitation group compared to the control group (95% confidence interval [CI], 32.4-89.5; P < .001). There were no differences in lung function, disability and psychological assessment, LOS, short-term recovery quality, postoperative complications, and mortality, except for forced vital capacity (FVC; 0.35 L higher in the prehabilitation group, 95% CI, 0.05-0.66; P = .021). CONCLUSIONS A 2-week, home-based, multimodal prehabilitation program could produce clinically relevant improvements in perioperative functional capacity in patients undergoing VATS lobectomy for lung cancer.
Databáze: OpenAIRE
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