title: High-intensity training following lung cancer surgery: a randomised controlled trial.
abstract: 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 randomised 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 standard 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 randomised 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 stand (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 clinically 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.
  
  
  BACKGROUND
  NCT01748981.
authors.affiliation: Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: E
authors.initials: E
authors.lastname: Edvardsen
authors.affiliation: Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway Faculty of Medicine, University of Oslo, Norway.
authors.forename: O H
authors.initials: OH
authors.lastname: Skjønsberg
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Holme
authors.affiliation: Faculty of Medicine, University of Oslo, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Nordsletten
authors.affiliation: Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway.
authors.forename: F
authors.initials: F
authors.lastname: Borchsenius
authors.affiliation: Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: S A
authors.initials: SA
authors.lastname: Anderssen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001823:Body Composition; D002289:Carcinoma, Non-Small-Cell Lung / Q000534:rehabilitation* / Q000601:surgery; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000502:physiology; D010101:Oxygen Consumption; D010349:Patient Compliance; D064797:Physical Conditioning, Human / Q000379:methods*; D010809:Physical Fitness / Q000502:physiology; D011013:Pneumonectomy; D011788:Quality of Life; D055070:Resistance Training / Q000379:methods*; D016037:Single-Blind Method; D016138:Walking / Q000502:physiology
keywords: Exercise; Non-Small Cell Lung Cancer; Pulmonary Rehabilitation