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. 2017 Jun;9(6):1584-1591.
doi: 10.21037/jtd.2017.05.49.

Effectiveness of perioperative pulmonary rehabilitation in thoracic surgery

Attila Vagvolgyi  1 , Zsolt Rozgonyi  2 , Maria Kerti  3 , Paul Vadasz  1 , Janos Varga  2
Affiliations

Effectiveness of perioperative pulmonary rehabilitation in thoracic surgery

Attila Vagvolgyi et al. J Thorac Dis. 2017 Jun.

Abstract

Background: Functional condition is crucial for operability of patients with lung cancer and/or chronic respiratory diseases. The aim of the study was to measure changes of functional and quality of life parameters in terms of the effectiveness of perioperative pulmonary rehabilitation (PR).

Methods: A total of 208 COPD patients (age: 63±9 years, man/woman: 114/94, FEV1: 62±14%pred) participated in a perioperative PR program. The indication was primary lung cancer in 72% of the patients. The 68 patients participated in preoperative (PRE) rehabilitation, 72 in a pre- and postoperative rehabilitation (PPO) and 68 patients only in postoperative rehabilitation (POS). PR program included respiratory training techniques, individualized training and smoking cessation. Lung function tests, 6 minutes walking distance (6MWD) were measured before and after the rehabilitation. Quality of life tests [COPD Assessment Test (CAT) and Modified Medical Research Council Dyspnoea Scale (mMRC)] were evaluated as well.

Results: There was a significant improvement in FEV1 (PRE: 64±16 vs. 67±16%pred; PPO: 60±13 vs. 66±13%pred before the operation, 48±13 vs. 52±13%pred after the operation; POS: 56±16 vs. 61±14%pred, P<0.05) and 6MWD (PRE: 403±87 vs. 452±86 m; PPO: 388±86 vs. 439±83 m before, 337±111 vs. 397±105 m after the operation; POS: 362±89 vs. 434±94 m, P<0 0001). Significant improvement was detected in FVC, grip strength, mMRC and CAT questionnaires as an effectiveness of PR, also. Average intensive care duration was 3.8±5.2 days with vs. 3.1±3.6 without preoperative PR.

Conclusions: Improvements in exercise capacity and quality of life were seen following PR both before and after thoracic surgery.

Keywords: Perioperative pulmonary rehabilitation (perioperative PR); chest physiotherapy; chronic obstructive pulmonary disease (COPD); endurance training; lung cancer; thoracic surgery.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow of participants in the perioperative rehabilitation program.
Figure 2
Figure 2
Improvement of maximal exercise capacity measured by 6-minute walking test, PRE-preoperative rehabilitation group, PPO-perioperative rehabilitation group, PPO-before: pulmonary rehabilitation before thoracic surgery, PPO-after: pulmonary rehabilitation after thoracic surgery, POS-postoperative rehabilitation group, mean ± standard deviation were presented in the columns.
Figure 3
Figure 3
Improvement of quality of life measured by COPD Assessment Test (CAT), PRE-preoperative rehabilitation group, PPO-perioperative rehabilitation group, PPO-before: pulmonary rehabilitation before thoracic surgery, PPO-after: pulmonary rehabilitation after thoracic surgery, POS-postoperative rehabilitation group, mean ± standard deviation were presented in the columns. COPD, chronic obstructive pulmonary disease.
See this image and copyright information in PMC

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