title: Effects of a Training Intervention for Enhancing Recovery after Ivor-Lewis Esophagus Surgery: A Randomized Controlled Trial.
abstract: OBJECTIVE
  There is a risk of decreased physical function, quality of life and persistent pain after open surgery for esophageal cancer. There are currently no studies that evaluate the effect of any postoperative intervention, including physical exercises, after this type of surgery. The aim of the study was therefore to evaluate the effect of a training intervention after Ivor-Lewis resection of the esophagus.
  
  
  METHODS
  Patients scheduled for esophagus resection according to Ivor-Lewis were randomized to an intervention group or a control group. The training intervention started at discharge and lasted three months. Before discharge, patients were given three leaflets with exercises to increase range of motion in the affected area and exercises aiming to restore lung function and physical function. All exercises were described in detail and the patients carried out the ones in the first program under supervision. Before surgery and three months after discharge, the patients estimated their level of physical function, level of physical activity, and quality of life. They also underwent spirometry, measurements of range of motion in the rib cage, spine, and shoulders, and three functional tests. Comparisons of differences within and between the groups were made.
  
  
  RESULTS
  A total of 43 of 64 randomized patients participated in the follow-up. Postoperatively, the patients in the intervention group had a significantly higher degree of physical function and less deteriorated range of motion in right shoulder flexion and thoracic left lateral flexion. There were no significant differences between the groups in lung function, pain, or quality of life.
  
  
  CONCLUSIONS
  The results of the three-month intervention indicate that specific training can positively affect physical function and range of motion to preoperative values. The intervention was well tolerated, and no side effects were registered.
authors.affiliation: 1 Department of Physical Therapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|2 Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.|3 Department of Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Fagevik Olsén
authors.affiliation: 1 Department of Physical Therapy, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Kjellby Wendt
authors.affiliation: 4 Department of Otorhinolaryngology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: E
authors.initials: E
authors.lastname: Hammerlid
authors.affiliation: 3 Department of Surgery, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: U
authors.initials: U
authors.lastname: Smedh
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010353:Patient Education as Topic / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology / Q000534:rehabilitation; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012016:Reference Values; D018570:Risk Assessment; D013147:Spirometry; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Esophagus cancer; esophageal resection; pain; physical activity; quality of life; range of motion