Effects of presurgical exercise training on cardiorespiratory fitness among patients undergoing thoracic surgery for malignant lung lesions

Abstract

BACKGROUND.To determine the effects of preoperative exercise training on cardiorespiratory fitness in patients undergoing thoracic surgery for malignant lung lesions. METHODS.Using a single-group design, 25 patients with suspected operable lung cancer were provided with structured exercise training until surgical resection.Exercise training consisted of 5 endurance cycle ergometry sessions per week at intensities varying from 60% to 100% of baseline peak oxygen consumption (VO 2peak ). Participants underwent cardiopulmonary exercise testing, 6-minute walk (6MW), and pulmonary function testing at baseline, immediately before, and 30 days after surgical resection. RESULTS.Five patients were deemed ineligible before surgical resection and were removed from the analysis. Of the remaining 20 patients follow-up assessments were obtained for 18 (90%) before resection and 13 (65%) patients postresection.The overall adherence rate was 72%. Intention-to-treat analysis indicated that mean VO 2peak increased by 2.4 mL Á kg 21 Á min 21 (95% confidence interval [CI], 1.0-3.8; P 5 .002) and 6MW distance increased 40m (95% CI, 16-64; P 5 .003) baseline to presurgery. Per protocol analyses indicated that patients who attended !80% of prescribed sessions increased VO 2peak and 6MWD by 3.3 mL Á kg 21 Á min 21 (95% CI, 1.1-5.4; P 5 .006) and 49 meters (95% CI, 12-85; P 5 .013), respectively. Exploratory analyses indicated that presurgical exercise capacity decreased postsurgery, but did not decrease beyond baseline values. CONCLUSIONS.Preoperative exercise training is a beneficial intervention to improve cardiorespiratory fitness in patients undergoing pulmonary resection. This benefit may have important implications for surgical outcome and postsurgical recovery in this population. Larger randomized controlled trials are war-

Erratum to: Exercise Therapy in the Management of Solid Tumors

“…Results indicated that mean VO 2peak increased by 2.4 mL kg -1 min -1 from baseline to presurgery. Exploratory analyses indicated that presurgical VO 2peak decreased postsurgery, but did not decrease beyond baseline values [43]. Similarly, Bobbio et al [44].…”

Trends in Nonoperative Treatment Modalities Prior to Cervical Surgery and Impact on Patient-Derived Outcomes: Two-Year Analysis of 1522 Patients From the Prospective Spine Treatment Outcome Study

“…For radiculopathy patients, PT prior to surgery, in general, has been associated with beneficial effects on postoperative patient outcomes. [19][20][21][22][23][24] In the current study, the difference in baseline functioning, age, and smoking history between those patients receiving PT and those who did not could account for some of the postoperative differences observed. These factors could influence surgical outcomes independently of the use of PT.…”

Exercise therapy across the prostate cancer continuum

“…14 Even for individuals who have not been chronically engaging in regular exercise, there is evidence to suggest that intensive exercise training interventions in the acute setting before surgery may be beneficial. In a cohort of patients undergoing surgical resection of malignant lung lesions, Jones et al 51 found an improvement in cardiorespiratory fitness (mean VO 2Peak increased by 2.4 ml kg À1 per min) after only 4-6 weeks of presurgical structured exercise training. Several studies investigating cardiac surgery patients have demonstrated that surgical complications are inversely associated with exercise capacity.…”