In-hospital physiotherapy improves physical activity level after lung cancer surgery: a randomized controlled trial

Abstract

Objectives: Patients undergoing lung cancer surgery are routinely offered physiotherapy. Despite its routine use, effects on postoperative physical recovery have yet not been demonstrated. The aim of this study was to investigate whether physiotherapy could improve postoperative in-hospital physical activity level and physical capacity.

Design: Single-blind randomized controlled trial.

Setting: Thoracic surgery department at a University Hospital.

Participants: Patients undergoing elective thoracic surgery (n=94) for confirmed or suspected lung cancer were assessed during hospital stay.

Intervention: Daily physiotherapy, consisting of mobilization, ambulation, shoulder exercises and breathing exercises. The control group received no physiotherapy treatment.

Outcomes: In-hospital physical activity assessed with the Actigraph GT3X+ accelerometer, six-minute walk test, spirometry and dyspnea scores.

Results: The treatment group reached significantly more accelerometer counts (2010 (1508) vs 1629 (1146), mean difference 495 [95% CI 44 to 1109]), and steps per hour (49 (47) vs 37 (34), mean difference 14 [95% CI 3 to 30]), compared to the control group, during the first three postoperative days. No significant differences in six-minute walk test (percent of preoperative 71% vs 79%, P=0.13), spirometry (FEV1 percent of preoperative 69% vs 69%, P=0.83) or dyspnoea (M-MRC 2 vs 2, P=0.74) between the groups were found.

Conclusions: Patients receiving in-hospital physiotherapy showed increased level of physical activity during the first days after lung cancer surgery, compared to an untreated control group. However, no effects on the six-minute walk test or spirometric values were found. The clinical importance of an increased physical activity level during the early postoperative period needs to be further evaluated.

Clinical trial registration number: NCT01961700.

Keywords: Lung cancer; Physical activity; Physical therapy; Randomized clinical trial.