title: Comparison of the effects of pulmonary rehabilitation with chest physical therapy on the levels of fibrinogen and albumin in patients with lung cancer awaiting lung resection: a randomized clinical trial.
abstract: BACKGROUND
  Systemic inflammation plays an important role in the initiation, promotion, and progression of lung carcinogenesis. In patients with non-small cell lung cancer (NSCLC), fibrinogen levels correlate with neoplasia. Here we compared the effects of pulmonary rehabilitation (PR) with chest physical therapy (CPT) on fibrinogen and albumin levels in patients with LC and previous inflammatory lung disease awaiting lung resection.
  
  
  METHODS
  We conducted a randomized clinical trial with 24 patients who were randomly assigned to Pulmonary Rehabilitation (PR) and Chest Physical Therapy (CPT) groups. Each group underwent training 5 days weekly for 4 weeks. All patients were assessed before and after four weeks of training through clinical assessment, measurement of fibrinogen and albumin levels, spirometry, 6-minute Walk Test (6MWT), quality of life survey, and anxiety and depression scale. PR involved strength and endurance training, and CPT involved lung expansion techniques. Both groups attended educational classes.
  
  
  RESULTS
  A mixed between-within subjects analysis of variance (ANOVA) revealed a significant interaction between time (before and after intervention) and group (PR vs. CPT) on fibrinogen levels (F(1, 22)=0.57, p<0.0001) and a significant main effect of time (F(1, 22)=0.68, p=0.004). Changes in albumin levels were not statistically significant relative to the interaction effect between time and group (F(1, 22)=0.96, p=0.37) nor the main effects of time (F(1, 22)=1.00, p=1.00) and group (F(1, 22 )=0.59, p=0.45). A mixed between-within subjects ANOVA revealed significant interaction effects between time and group for the peak work rate of the unsupported upper limb exercise (F(1, 22)=0.77, p=0.02), endurance time (F(1, 22)=0.60, p=0.001), levels of anxiety (F(1, 22)=0.60, p=0.002) and depression (F(1, 22)=0.74, p=0.02), and the SF-36 physical component summary (F(1, 22)=0.83, p=0.07).
  
  
  CONCLUSIONS
  PR reduced serum fibrinogen levels, improved functional parameters, and quality of life of patients with LC and inflammatory lung disease awaiting lung resection.
  
  
  BACKGROUND
  Current Controlled Trials RBR-3nm5bv.
authors: Maria Tereza Aguiar Pessoa
authors: MT
authors: Morano
authors: Rafael
authors: R
authors: Mesquita
authors: Guilherme Pinheiro Ferreira
authors: GP
authors: Da Silva
authors: Amanda Souza
authors: AS
authors: Araújo
authors: Juliana Maria De Sousa
authors: JM
authors: Pinto
authors: Antero Gomes
authors: AG
authors: Neto
authors: Cyntia Maria Sampaio
authors: CM
authors: Viana
authors: Manoel Odorico
authors: MO
authors: De Moraes Filho
authors: Universidade Federal do Ceará - UFC, Fortaleza, Brazil. eanes@fortalnet.com.br.
authors: Eanes Delgado Barros
authors: ED
authors: Pereira
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology; D001945:Breathing Exercises; D002289:Carcinoma, Non-Small-Cell Lung / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000209:etiology; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology; D005082:Physical Exertion / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012709:Serum Albumin / Q000378:metabolism*; D013147:Spirometry; D013997:Time Factors; D034941:Upper Extremity / Q000502:physiology
chemical_list: D012709:Serum Albumin; D005340:Fibrinogen