Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
Department of Physical Medicine and Rehabilitation, Parc de Salut Mar, Hospital del Mar, Hospital de l'Esperança, Barcelona, Spain.
Eur J Phys Rehabil Med. 2019 Feb;55(1):113-122. doi: 10.23736/S1973-9087.18.05156-0. Epub 2018 Jul 6.
Lung resection surgery further decreases exercise capacity and negatively affects respiratory muscle function in patients with non-small cell lung cancer (NSCLC). The best design for exercise interventions in these patients has not been determined yet.
To assess the impact of aerobic exercise and high-intensity respiratory muscle training on patient outcomes following lung cancer resection surgery.
Prospective, single-blind, pilot randomized controlled trial.
Outpatient cardiopulmonary rehabilitation unit of two university hospitals.
Thirty-seven patients with NSCLC after tumor resection.
Patients were randomly assigned to exercise training or usual post-operative care. The training program consisted of aerobic exercises and high-intensity respiratory muscle training (24 supervised sessions, 3 per week, 8 weeks). Primary outcome was exercise capacity assessed with peak oxygen uptake (VO2peak) during cardiopulmonary exercise test. Secondary outcomes included changes in respiratory muscle strength, levels of serum insulin growth factor I (IGF-I) and IGF binding protein 3 (IGFBP-3), and quality of life assessed with the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) questionnaire.
The 8-week training program was associated with significant improvement in VO2peak (2.13 mL/Kg/min [95%CI 0.06 to 4.20]), maximal inspiratory and expiratory pressures (18.96 cmH2O [95% CI 2.7 to 24.1] and 18.58 cmH2O [95% CI 4.0 to 33.1], respectively) and IGFBP-3 (0.61 µg/mL [%95 CI 0.1 to 1.12]). No significant differences were observed in the EORTC QLQ-C30.
An 8-week exercise program consisting of aerobic exercise and high-intensity respiratory muscle training improved exercise capacity, respiratory muscle strength, and serum IGFBP-3 levels in NSCLC patients after lung resection. There was no impact on the other outcomes assessed.
A combination of aerobic exercise and respiratory muscle training could be included in the rehabilitation program of deconditioned patients with NSCLC after lung resection surgery.
非小细胞肺癌（NSCLC）患者的肺切除术进一步降低了运动能力，并对呼吸肌功能产生负面影响。目前尚未确定此类患者进行运动干预的最佳设计方案。
评估有氧运动和高强度呼吸肌训练对肺癌切除术后患者的影响。
前瞻性、单盲、试验性随机对照试验。
两所大学医院的门诊心肺康复病房。
37 例 NSCLC 肿瘤切除术后患者。
患者随机分为运动训练组或术后常规护理组。训练方案包括有氧运动和高强度呼吸肌训练（24 次监督训练，每周 3 次，共 8 周）。主要结局指标为心肺运动试验中峰值摄氧量（VO2peak）评估的运动能力。次要结局指标包括呼吸肌力量、血清胰岛素样生长因子 I（IGF-I）和 IGF 结合蛋白 3（IGFBP-3）水平的变化，以及欧洲癌症研究与治疗组织（EORTC）生命质量问卷（QLQ-C30）评估的生活质量。
为期 8 周的训练方案与 VO2peak（2.13 mL/Kg/min [95%CI 0.06 至 4.20]）、最大吸气和呼气压力（18.96 cmH2O [95%CI 2.7 至 24.1]和 18.58 cmH2O [95%CI 4.0 至 33.1]）和 IGFBP-3（0.61 µg/mL [95%CI 0.1 至 1.12]）的显著改善相关。在 EORTC QLQ-C30 方面未观察到显著差异。
一项由有氧运动和高强度呼吸肌训练组成的 8 周运动方案可改善 NSCLC 患者肺切除术后的运动能力、呼吸肌力量和血清 IGFBP-3 水平。对其他评估的结局没有影响。
肺切除术后条件不佳的 NSCLC 患者的康复方案中可纳入有氧运动和呼吸肌训练的组合。
