Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial.
OBJECTIVE
To evaluate the effect of a combined hospital plus home exercise programme following curative surgery for non-small cell lung cancer (NSCLC).


METHODS
Randomised controlled trial.


METHODS
Teaching hospital.


METHODS
One hundred and thirty-one subjects with NSCLC admitted for curative surgery.


METHODS
Participants were randomised to usual care or a hospital plus home exercise programme.


RESULTS
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 [standard 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 (-26m, 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.
NIHR Biomedical Research Centre, Guy's and St Thomas' Foundation Trust and Kings College London, UK.
G
G
Arbane
NIHR Biomedical Research Centre, Guy's and St Thomas' Foundation Trust and Kings College London, UK; Division of Health and Social Care Research, King's College London, UK.
A
A
Douiri
NIHR Biomedical Research Centre, Guy's and St Thomas' Foundation Trust and Kings College London, UK.
N
N
Hart
NIHR Respiratory Biomedical Research Unit at Royal Brompton and Harefield NHS Foundation Trust and Imperial College, London, UK.
N S
NS
Hopkinson
Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Leicester, UK.
S
S
Singh
King's College London, Denmark Hill Campus, London, UK.
C
C
Speed
King's College London, Denmark Hill Campus, London, UK.
B
B
Valladares
King's College London, Denmark Hill Campus, London, UK. Electronic address: rachel.garrod@nhs.net.
R
R
Garrod
D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000534:rehabilitation* / Q000601:surgery*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008175:Lung Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011788:Quality of Life
Exercise; Non-small cell lung cancer; Surgery; Thoracotomy