Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Outpatient Nursing, Asan Medical Center, Seoul, Republic of Korea.
JMIR Mhealth Uhealth. 2019 Feb 4;7(2):e11094. doi: 10.2196/11094.
Advanced lung cancer patients often have chronic lung disease with reduced exercise capacities and various symptoms leading to altered quality of life (QoL). No studies have assessed pulmonary rehabilitation (PR) employing a mobile app and an Internet of Things device in advanced lung cancer patients undergoing chemotherapy.
This study aimed to determine the feasibility and efficacy of smartphone app-based PR on exercise capacity, symptom management, and QoL in patients with advanced lung cancer undergoing chemotherapy.
A total of 100 patients were recruited in a prospective, single-arm intervention study using a smartphone app-based PR program for 12 weeks. Exercise capacity (6-min walking distance, 6MWD), QoL, symptom scale scores, and distress indexes were investigated.
A total of 90 patients completed the PR program. The most common cause of drop out was hospitalization because of cancer progression. After PR, there was significant improvement in the 6MWD; 380.1 m (SD 74.1) at baseline, 429.1 m (SD 58.6) at 6 weeks (P<.001), and 448.1 m (SD 50.0) at 12 weeks (P<.001). However, the dyspnea scale score showed no significant improvement in the patients overall, but there was a trend for improvement in those with a stable tumor response (P=.07). Role (P=.02), emotional (P<.001), and social functioning (P=.002) scale scores showed significant improvement after PR. Symptom scale scores for fatigue (P<.001), anorexia (P=.047), and diarrhea (P=.01) also showed significant improvement. There was significant improvement in depression (P=.048) and anxiety (P=.01), whereas there was no significant change in QoL (P=.06) and severity of pain (P=.24).
Smartphone app-based PR represents an effective and feasible program to improve exercise capacity and to manage symptoms and distress in patients with advanced lung cancer who are undergoing chemotherapy.
晚期肺癌患者常患有慢性肺部疾病，运动能力下降，各种症状导致生活质量（QoL）改变。目前尚无研究评估在接受化疗的晚期肺癌患者中使用移动应用程序和物联网设备进行肺康复（PR）。
本研究旨在确定基于智能手机应用程序的 PR 对接受化疗的晚期肺癌患者的运动能力、症状管理和 QoL 的可行性和疗效。
采用前瞻性、单臂干预研究，对 100 例患者使用基于智能手机应用程序的 PR 程序进行 12 周治疗。评估运动能力（6 分钟步行距离，6MWD）、QoL、症状量表评分和痛苦指数。
共有 90 例患者完成了 PR 计划。退出的主要原因是因癌症进展而住院。 PR 后，6MWD 显著改善；基线时为 380.1m（SD 74.1），6 周时为 429.1m（SD 58.6）（P<.001），12 周时为 448.1m（SD 50.0）（P<.001）。然而，患者整体呼吸困难量表评分无显著改善，但肿瘤稳定反应者有改善趋势（P=.07）。PR 后，角色（P=.02）、情感（P<.001）和社会功能（P=.002）量表评分均显著改善。疲劳（P<.001）、厌食（P=.047）和腹泻（P=.01）的症状量表评分也显著改善。抑郁（P=.048）和焦虑（P=.01）显著改善，而 QoL（P=.06）和疼痛严重程度（P=.24）无显著变化。
基于智能手机应用程序的 PR 是一种有效且可行的方案，可改善接受化疗的晚期肺癌患者的运动能力，并能管理其症状和痛苦。
