Multimodal Prehabilitation for Lung Cancer Surgery: A Randomized Controlled Trial

Ann Thorac Surg. 2021 Nov;112(5):1600-1608. doi: 10.1016/j.athoracsur.2020.11.022. Epub 2020 Dec 13.

Abstract

Background: The study was conducted to determine whether a multimodal prehabilitation program enhances postoperative functional recovery compared with multimodal rehabilitation.

Methods: Patients scheduled for non-small cell lung cancer resection were randomized to 2 groups receiving home-based moderate-intensity exercise, nutritional counseling with whey protein supplementation, and anxiety-reducing strategies for 4 weeks before the operation (PREHAB, n = 52) or 8 weeks after (REHAB, n = 43). Functional capacity (FC) was measured by the 6-minute walk test (6MWT) at baseline, immediately before the operation, and 4 and 8 weeks after operation. All patients were treated according to enhanced recovery pathway guidelines.

Results: There was no difference in FC at any point during the perioperative period between the 2 multimodal programs. By 8 weeks after operation, both groups returned to baseline FC, and a similar proportion of patients (>75%) in both groups had recovered to their baseline.

Conclusions: In patients undergoing surgical resection for lung cancer within the context of an enhanced recovery pathway, multimodal prehabilitation initiated 4 weeks before operation is as effective in recovering FC as multimodal rehabilitation.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Carcinoma, Non-Small-Cell Lung / rehabilitation
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Female
  • Humans
  • Lung Neoplasms / rehabilitation
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Preoperative Exercise*
  • Recovery of Function*
  • Single-Blind Method