Potential effectiveness of a surgeon-delivered exercise prescription and an activity tracker on pre-operative exercise adherence and aerobic capacity of lung cancer patients

Surg Oncol. 2021 Jun:37:101525. doi: 10.1016/j.suronc.2021.101525. Epub 2021 Mar 5.

Abstract

Objectives: Pre-operative exercise may improve functional outcomes for lung cancer patients, but barriers associated with cost, resources, and burden make it challenging to deliver pre-operative exercise programs. The goal of this proof-of-concept study was to determine level of moderate-vigorous physical activity (MVPA) and change in aerobic capacity after participation in a home-based pre-operative exercise intervention.

Materials and methods: Eighteen patients scheduled for surgery for suspected stage I-III lung cancer received an exercise prescription from their surgeon and wore a commercially-available device that tracked their daily MVPA throughout the pre-operative period. Descriptive statistics were used to calculate adherence to the exercise prescription. A one-sample t-test was used to explore change in aerobic capacity from baseline to the day of surgery.

Results: Participants exhibited a mean of 20.4 (sd = 46.2) minutes of MVPA per day during the pre-operative period. On average, the sample met the goal of 30 min of MVPA on 16.4% of the days during the pre-operative period. The mean distance achieved at baseline for the 6-min walk test was 456.7 m (sd = 72.9), which increased to 471.1 m (sd = 88.4) on the day of surgery. This equates to a mean improvement of 13.8 m (sd = 37.0), but this difference was not statistically different from zero (p = 0.14). Eight of the 17 participants (47%) demonstrated a clinically significant improvement of 14 m or more.

Conclusion: A surgeon-delivered exercise prescription plus an activity tracker may promote clinically significant improvement in aerobic capacity and MVPA engagement among patients with lung cancer during the pre-operative period, but may need to be augmented with more contact with and support from practitioners over time to maximize benefits.

Trial registration: The study protocol was registered with ClinicalTrials.gov prior to initiating participant recruitment (NCT03162718).

Keywords: Activity tracker; Exercise; Neoplasms; Rehabilitation; Telemedicine; Thoracic surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Exercise / statistics & numerical data*
  • Exercise Therapy / methods*
  • Exercise Therapy / statistics & numerical data
  • Female
  • Fitness Trackers
  • Humans
  • Lung Neoplasms / surgery
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • New Hampshire
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Preoperative Care / methods*
  • Preoperative Period
  • Prescriptions
  • Surgeons

Associated data

  • ClinicalTrials.gov/NCT03162718