Multidisciplinary home-based rehabilitation in inoperable lung cancer: a randomised controlled trial

Lara Edbrooke^{1

2}, Sanchia Aranda^{3

4}, Catherine L Granger^{1

5}, Christine F McDonald^{6

7}, Mei Krishnasamy^{8

9}, Linda Mileshkin^{10

11}, Ross A Clark¹², Ian Gordon¹³, Louis Irving¹⁴, Linda Denehy^{15

16}

Affiliations

¹ Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia.
² Allied Health Service, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
³ Cancer Council Australia, Sydney, New South Wales, Australia.
⁴ Department of Nursing, The University of Melbourne, Parkville, Victoria, Australia.
⁵ Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶ Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
⁷ Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia.
⁸ Department of Nursing and Centre for Cancer Research, The University of Melbourne, Parkville, Victoria, Australia.
⁹ Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia.
¹⁰ Department of Medical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
¹¹ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
¹² University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
¹³ Statistical Consulting Centre, The University of Melbourne, Parkville, Victoria, Australia.
¹⁴ Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
¹⁵ Allied Health Service, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia l.denehy@unimelb.edu.au.
¹⁶ School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia.

PMID: 31048509
DOI: 10.1136/thoraxjnl-2018-212996

Randomized Controlled Trial

Multidisciplinary home-based rehabilitation in inoperable lung cancer: a randomised controlled trial

Lara Edbrooke et al. Thorax. 2019 Aug.

. 2019 Aug;74(8):787-796.

doi: 10.1136/thoraxjnl-2018-212996. Epub 2019 May 2.

Authors

Affiliations

¹ Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia.
² Allied Health Service, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
³ Cancer Council Australia, Sydney, New South Wales, Australia.
⁴ Department of Nursing, The University of Melbourne, Parkville, Victoria, Australia.
⁵ Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶ Department of Respiratory and Sleep Medicine, Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
⁷ Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia.
⁸ Department of Nursing and Centre for Cancer Research, The University of Melbourne, Parkville, Victoria, Australia.
⁹ Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia.
¹⁰ Department of Medical Oncology, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
¹¹ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
¹² University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
¹³ Statistical Consulting Centre, The University of Melbourne, Parkville, Victoria, Australia.
¹⁴ Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
¹⁵ Allied Health Service, The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia l.denehy@unimelb.edu.au.
¹⁶ School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia.

PMID: 31048509
DOI: 10.1136/thoraxjnl-2018-212996

Abstract

Background: Lung cancer is associated with poor health-related quality of life (HRQoL) and high symptom burden. This trial aimed to assess the efficacy of home-based rehabilitation versus usual care in inoperable lung cancer.

Methods: A parallel-group, assessor-blinded, allocation-concealed, randomised controlled trial. Eligible participants were allocated (1:1) to usual care (UC) plus 8 weeks of aerobic and resistance exercise with behaviour change strategies and symptom support (intervention group (IG)) or UC alone. Assessments occurred at baseline, 9 weeks and 6 months. The primary outcome, change in between-group 6 min walk distance (6MWD), was analysed using intention-to-treat (ITT). Subsequent analyses involved modified ITT (mITT) and included participants with at least one follow-up outcome measure. Secondary outcomes included HRQoL and symptoms.

Results: Ninety-two participants were recruited. Characteristics of participants (UC=47, IG=45): mean (SD) age 64 (12) years; men 55%; disease stage n (%) III=35 (38) and IV=48 (52); radical treatment 46%. There were no significant between-group differences for the 6MWD (n=92) at 9 weeks (p=0.308) or 6 months (p=0.979). The mITT analyses of 6MWD between-group differences were again non-significant (mean difference (95% CI): 9 weeks: -25.4 m (-64.0 to 13.3), p=0.198 and 6 months: 41.3 m (-26.7 to 109.4), p=0.232). Significant 6-month differences, favouring the IG, were found for HRQoL (Functional Assessment of Cancer Therapy-Lung: 13.0 (3.9 to 22.1), p=0.005) and symptom severity (MD Anderson Symptom Inventory-Lung Cancer: -2.2 (-3.6 to -0.9), p=0.001).

Conclusions: Home-based rehabilitation did not improve functional exercise capacity but there were improvements in patient-reported exploratory secondary outcomes measures observed at 6 months.

Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12614001268639).

Keywords: exercise; non-small cell lung cancer.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Comment in

Should pulmonary rehabilitation be a standard of care in lung cancer?
Steiner MC. Steiner MC. Thorax. 2019 Aug;74(8):725-726. doi: 10.1136/thoraxjnl-2019-213157. Epub 2019 May 15. Thorax. 2019. PMID: 31092673 No abstract available.
Critically appraised paper: In people with inoperable lung cancer, home-based rehabilitation provides no benefit over usual care in optimising functional exercise capacity [commentary].
Quist M. Quist M. J Physiother. 2020 Jan;66(1):57. doi: 10.1016/j.jphys.2019.11.009. Epub 2019 Dec 13. J Physiother. 2020. PMID: 31843421 No abstract available.
Critically appraised paper: In people with inoperable lung cancer, home-based rehabilitation provides no benefit over usual care in optimising functional exercise capacity [synopsis].
Cavalheri V. Cavalheri V. J Physiother. 2020 Jan;66(1):57. doi: 10.1016/j.jphys.2019.11.010. Epub 2019 Dec 16. J Physiother. 2020. PMID: 31859150 No abstract available.

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Associated data

ANZCTR/ACTRN12614001268639

LinkOut - more resources

Full Text Sources
- HighWire
- Ovid Technologies, Inc.
Medical
- MedlinePlus Consumer Health Information
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Multidisciplinary home-based rehabilitation in inoperable lung cancer: a randomised controlled trial

Affiliations

Multidisciplinary home-based rehabilitation in inoperable lung cancer: a randomised controlled trial

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

Publication types

MeSH terms

Associated data

LinkOut - more resources

Full Text Sources

Medical