Effect of postsurgical rehabilitation programmes in patients operated for lung cancer: A systematic review and meta-analysis.

OBJECTIVE

To review the evidence concerning the effects of postoperative exercise interventions on exercise capacity and health-related quality of life following resection for non-small cell lung cancer, and to review whether different initiation times of exercise produce different effects on exercise capacity.

DATA SOURCES

Comprehensive literature search of MEDLINE, Embase, CENTRAL, CINAHL and PEDro.

STUDY SELECTION

Randomized controlled trials examining the effects of exercise interventions were eligible for inclusion.

DATA EXTRACTION

Postoperative outcome measurements were extracted and the quality of evidence was graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group.

DATA SYNTHESIS

Four randomized controlled trials were identified involving 262 participants. Short-term follow-up (12-20 weeks) showed significantly higher exercise capacity and physical component of health-related quality of life in the intervention group (standardized mean difference (SMD) 0.48; 95% confidence interval (CI) 0.04-0.93) compared with the control group (SMD 0.50; 95% CI 0.19-0.82). There was no difference between the effect of late- and early-initiated exercise intervention.

CONCLUSION

Exercise has a small-to-moderate effect at short-term follow-up on exercise capacity and the physical component of health-related quality of life in patients operated for lung cancer. The long-term effects of exercise capacity are unknown. Early-initiated exercise programmes (2 weeks post-operation) did not show an effect on exercise capacity. These findings should be interpreted with caution.