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. 2017 Jul;9(7):1919-1929.
doi: 10.21037/jtd.2017.06.15.

Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial

Jian Huang  1 , Yutian Lai  1 , Xudong Zhou  1 , Shuangjiang Li  1 , Jianhua Su  2 , Mei Yang  1 , Guowei Che  1
Affiliations

Short-term high-intensity rehabilitation in radically treated lung cancer: a three-armed randomized controlled trial

Jian Huang et al. J Thorac Dis. 2017 Jul.

Abstract

Background: The feasibility and practicality of preoperative rehabilitation (PR) programs remains quite controversial in the treatment of lung cancer (LC). This study explored whether a short-term high-intensity rehabilitation program could improve postoperative outcomes compared to those achieved with conventional inspiratory muscle training (IMT).

Methods: A three-armed randomized controlled trial comparing the two training modalities and routine care was conducted in surgical LC patients. Patient groups received one of three treatment regimens: (I) high-intensity pulmonary rehabilitation (PR) that combined IMT with conventional resistance training (CRT) (combined PR group); (II) conventional PR (single IMT group); or (III) routine preoperative preparation (control group). The primary endpoint was a change in the occurrence of post-operative pulmonary complications (PPCs) that occurred within 30 days after surgery, while secondary endpoints included changes in length of hospital stay, quality of life (QoL) scores, 6-min walk distance (6-MWD) and peak expiratory flow (PEF).

Results: A total of 90 enrolled patients were randomized into three groups with a computer-based 1:1:1 ratio. The intention-to-treat analysis of the study revealed that, compared with the Control Group, the Combined PR Group had a significant increase in ∆6-MWD (by 32.67 m, P=0.002), ∆PEF (by 14.3 L/min, P=0.001), ∆global scores (by 3.7, P=0.035); and a reduced ∆average total hospital stay (by 3.2 d, P=0.001) and ∆postoperative stay (by 3.6 d, P=0.001). With regard to PPC rate, the Combined PR Group had a somewhat lower PPC severity (grade II-V) compared to the Control Group.

Conclusions: This hospital-based short-term program of PR combining high-intensity IMT with CRT was significantly superior to the conventional IMT program, indicating that this approach would be a feasible strategy for treating LC patients, especially those waiting operations with surgery-related risk factors.

Keywords: Short-term; high-intensity; lung cancer (LC); preoperative rehabilitation (PR).

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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
The study flow of the work. The intentional analysis was adopted in the study.
See this image and copyright information in PMC

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