Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial

Granger, Catherine L; Edbrooke, Lara; Antippa, Phillip; Wright, Gavin; McDonald, Christine F; Lamb, Karen E.; Irving, Louis; Krishnasamy, Meinir; Abo, Shaza; Whish-Wilson, Georgina A; Truong, Dominic; Denehy, Linda; Parry, Selina M.

doi:10.1136/bmjresp-2021-001189

Cited by 3 publications

(1 citation statement)

References 57 publications

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“…In CSCMP, psychological nurses perform psychological intervention on patients with lung cancer undergoing chemotherapy with psychological problems, to alleviate the adverse physical and mental experiences caused by the core symptom cluster. Exercise is an effective way to manage the core symptom cluster of patients with lung cancer undergoing chemotherapy [59,60]…”

Section: The Cscmp Has Clinical Operabilitymentioning

confidence: 99%

Construction of the core symptom cluster management program for patients with lung cancer undergoing chemotherapy: a Delphi study

Zhang,

Luo,

Mao

et al. 2024

Preprint

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Background: In recent years, the incidence of cancer has been on the rise worldwide due to environmental pollution, poor lifestyle habits, and increasing medical diagnoses. In China, the incidence and mortality of lung cancer both rank first among malignant tumors. In the process of cancer diagnosis and treatment, patients with lung cancer experience a serious symptom burden. Inadequate symptom management will aggravate the physical and mental pain of patients, and even delay or interrupt the treatment of the disease. Therefore, it is urgent to provide scientific symptom management programs for medical staff and patients with lung cancer. Objective: To construct the core symptom cluster management program for patients with lung cancer undergoing chemotherapy. Methods: Under the guidance of Symptom Management Theory, the draft program was formed through the literature supplement and clinical expert meeting based on the best evidence summary, and the final program was formed after two rounds of Delphi with 17 experts. Results: The draft program contains 35 entries in 3 time dimensions and 16 intervention dimensions. The final program, formed after two rounds of Delphi, consists of 12 entries in 7 different dimensions. In both rounds, Delphi issued and recovered 17 questionnaires, and the recovery rate was 100%. The expert authority coefficient was 0.888. The submission rate of expert opinions was 82.35% and 58.82%. The mean values of importance were 3.765-4.647 and 4.410-4.820. The full score frequency was 23.5-76.5 and 58.8-88.2. The coefficient of variation was 0.130-0.280 and 0.110-0.197. The Kendall’s W was 0.467 and 0.523, P < 0.05. The expert approval rate for the clinical usability of each item was 94.1%-100%. Conclusion: Under the guidance of Symptom Management Theory, the core symptom cluster management program for patients with lung cancer undergoing chemotherapy established in this study is scientific and credible, with clinical operability, and can guide medical staff and patients with lung cancer to carry out symptom management in complex clinical environments.

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Section: The Cscmp Has Clinical Operabilitymentioning

confidence: 99%

Construction of the core symptom cluster management program for patients with lung cancer undergoing chemotherapy: a Delphi study

Zhang,

Luo,

Mao

et al. 2024

Preprint

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Home-Based Exercise and Self-Management After Lung Cancer Resection

Granger,

Edbrooke,

Antippa

et al. 2024

JAMA Netw Open

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ImportancePatients with lung cancer have poor physical functioning and quality of life. Despite promising outcomes for those who undertake exercise programs, implementation into practice of previously tested hospital-based programs is rare.ObjectiveTo evaluate a home-based exercise and self-management program for patients after lung resection.Design, Setting, and ParticipantsA randomized clinical trial with assessor blinding was conducted among 116 patients undergoing surgery for non–small cell lung cancer from November 23, 2017, to July 31, 2023, at tertiary hospitals in Australia. Patients were followed up for 12 months postoperatively.InterventionPatients randomized to the intervention group received a postoperative 3-month home-based exercise and self-management program, supported by weekly physiotherapist-led telephone consultations. Patients randomized to the control group received usual care.Main Outcomes and MeasuresThe primary outcome was self-reported physical function (30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30] score) at 3 months. Secondary outcomes included objective measures of physical function and exercise capacity (at 3 and 6 months) and patient-reported outcomes including quality of life (at 3 and 6 months, with some questionnaires completed at 12 months). Analysis was performed on an intent-to-treat basis.ResultsA total of 1370 patients were screened, with 177 eligible and 116 consented (mean [SD] age, 66.4 [9.6] years; 68 women [58.6%]). Of these 116 patients, 58 were randomized to the intervention and 58 to the control. A total of 103 patients (88.8%) completed assessments at 3 months, 95 (81.9%) at 6 months, and 95 (81.9%) at 12 months. There were no statistically significant differences between the intervention and control groups for self-reported physical function (EORTC QLQ-C30 physical functioning domain score) at the 3-month primary end point (mean [SD] score, 77.3 [20.9] vs 76.3 [18.8]; mean difference, 1.0 point [95% CI, −6.0 to 8.0 points]). Patients in the intervention group, compared with the control group, had significantly greater exercise capacity (6-minute walk distance: mean difference, 39.7 m [95% CI, 6.8-72.6 m]), global quality of life (mean difference, 7.1 points [95% CI, 0.4-13.8 points]), and exercise self-efficacy (mean difference, 16.0 points [95% CI, 7.0-24.9 points]) at 3 months as well as greater objectively measured physical function (Short Physical Performance Battery score: mean difference, 0.8 points [95% CI, 0.1-1.6 points]), exercise capacity (6-minute walk distance: mean difference, 50.9 m [95% CI, 6.7-95.1 m]), and exercise self-efficacy (mean difference, 10.1 points [95% CI, 1.9-18.2 points]) at 6 months. One minor adverse event and no serious adverse events occurred.Conclusions and RelevanceIn this randomized clinical trial, a postoperative home-based exercise and self-management program did not improve self-reported physical function in patients with lung cancer. However, it did improve other important clinical outcomes. Implementation of this program into lung cancer care should be considered.Trial Registrationhttp://anzctr.org.au Identifier: ACTRN12617001283369

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Effect of tDCS combined with virtual reality for post-stroke cognitive impairment: a randomized controlled trial study protocol

Cheng,

Wang,

Zhou

et al. 2024

BMC Complement Med Ther

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Background Post-stroke cognitive impairment (PSCI) not only increases patient mortality and disability, but also adversely affects motor function and the ability to perform routine daily activities. Current therapeutic approaches for, PSCI lack specificity, primarily relying on and medication and traditional cognitive therapy supplemented by a limited array of tools. Both transcranial direct current stimulation (tDCS) and virtual reality (VR) training have demonstrated efficacy in improving cognitive performance among PSCI patients. Previous findings across various conditions suggest that implementing a therapeutic protocol combining tDCS and VR (tDCS - VR) may yield superior in isolation. Despite this, to our knowledge, no clinical investigation combining tDCS and VR for PSCI rehabilitation has been conducted. Thus, the purpose of this study is to explore the effects of tDCS - VR on PSCI rehabilitation. Methods This 4-week, single-center randomized clinical trial protocol will recruit 200 patients who were randomly assigned to one of four groups: Group A (tDCS + VR), Group B (tDCS + sham VR), Group C (sham tDCS + VR), Group D (sham tDCS + sham VR). All four groups will receive conventional cognitive rehabilitation training. The primary outcome measurement utilizes the Mini-Mental State Examination (MMSE). Secondary outcome measures include the Montreal Cognitive Assessment, Frontal Assessment Battery, Clock Drawing Test, Digital Span Test, Logic Memory Test, and Modified Barthel Index. Additionally, S-YYZ-01 apparatus for diagnosis and treating language disorders assesses subjects’ speech function. Pre- and post-four-week intervention assessments are conducted for all outcome measures. Functional near-infrared spectroscopy (fNIRS) is employed to observe changes in oxygenated hemoglobin (HbO), deoxy-hemoglobin (HbR), and total hemoglobin (HbT) in the cerebral cortex. Discussion Our hypothesis posits that the tDCS - VR therapy, in opposed to individual tDCS or VR interventions, could enhance cognitive function, speech ability and daily living skills in PSCI patients while concurrently augmenting frontal cortical activity. This randomized study aims to provide a robust theoretical foundation supported by scientific evidence for the practical implementation of the tDCS - VR combination as a secure and efficient PSCI rehabilitation approach. Trial registration Chictr.org.cn Identifier: ChiCTR2300070580. Registered on 17th April 2023.

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Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial

Cited by 3 publications

References 57 publications

Construction of the core symptom cluster management program for patients with lung cancer undergoing chemotherapy: a Delphi study

Construction of the core symptom cluster management program for patients with lung cancer undergoing chemotherapy: a Delphi study

Home-Based Exercise and Self-Management After Lung Cancer Resection

Effect of tDCS combined with virtual reality for post-stroke cognitive impairment: a randomized controlled trial study protocol

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