Department of Rehabilitation Medicine and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, PR China.
Medicine (Baltimore). 2024 Mar 8;103(10):e37285. doi: 10.1097/MD.0000000000037285.
Postoperative rehabilitation programs consisting of exercise training are considered effective for unselected lung cancer patients. However, whether postoperative exercise is beneficial to lung cancer patients comorbid with chronic obstructive pulmonary disease remains unknown.
Eighty-four patients diagnosed with both lung cancer and chronic obstructive pulmonary disease were randomized into the exercise group and control group. Both groups were given standard postoperative rehabilitation for 1 week. After that, oxygen therapy (if needed) and nebulization were given to the control group, while patients in the exercise group started to participate in exercise programs on the basis of receiving oxygen therapy and nebulization as in the control group. The exercise programs consisted of 24 training sessions.
In both groups, the functional status and the results of the pulmonary function test decreased from baseline to the endpoint. However, after surgery and the intervention program, both the maximal oxygen consumption in the cardiopulmonary exercise test and walking distance in the 6-minute walk test in the exercise group were significantly better than those in the control group [15.5 (±1.4) mL/kg/min vs 13.1 (±1.3) mL/kg/min, P = 0.016; 437.4 (±48.6) m vs 381.7 (±40.5) m, P = 0.040]. Force vital capacity and forced expiratory volume in the first second in the exercise group were better than those in the control group, but the differences were not statistically significant [1798.1 (±298.9) mL vs 1664.0 (±329.7) mL, P = 0.254; 1155.7 (±174.3) mL vs 967.4 (±219.4) mL, P = 0.497]. The decline in the standard score of the QLQ-C30 (V3.0) was smaller in the exercise group, but the difference did not meet a statistically significant level [61.7 (±5.7) vs 58.4 (±9.3), P = 0.318].
This study demonstrates that a short-term postoperative exercise training program can facilitate the recovery of functional capacity in lung cancer patients with comorbidities of chronic obstructive pulmonary disease.
包含运动训练的术后康复方案被认为对非选择性肺癌患者有效。然而,术后运动是否对合并慢性阻塞性肺疾病的肺癌患者有益尚不清楚。
84 例肺癌合并慢性阻塞性肺疾病患者被随机分为运动组和对照组。两组均接受标准术后康复治疗 1 周。之后,对照组给予氧疗(必要时)和雾化吸入治疗,而运动组在接受与对照组相同的氧疗和雾化吸入治疗的基础上开始进行运动方案。运动方案包括 24 次训练课程。
两组患者的功能状态和肺功能测试结果均从基线下降至终点。然而,在手术后和干预方案后,运动组的心肺运动试验中最大摄氧量和 6 分钟步行试验中的步行距离均明显优于对照组[15.5(±1.4)ml/kg/min 比 13.1(±1.3)ml/kg/min,P=0.016;437.4(±48.6)m 比 381.7(±40.5)m,P=0.040]。运动组的用力肺活量和第一秒用力呼气容积均优于对照组,但差异无统计学意义[1798.1(±298.9)ml 比 1664.0(±329.7)ml,P=0.254;1155.7(±174.3)ml 比 967.4(±219.4)ml,P=0.497]。运动组 QLQ-C30(V3.0)标准评分下降较小,但差异无统计学意义[61.7(±5.7)比 58.4(±9.3),P=0.318]。
本研究表明,短期术后运动训练方案可促进合并慢性阻塞性肺疾病的肺癌患者的功能能力恢复。