Exercise rehabilitation on patients with non-small cell lung cancer: A meta-analysis of randomized controlled trials

Abstract

BACKGROUND Lung cancer is one of the most common and deadly cancers worldwide. As the disease progresses and due to the side effects of treatment, patients’ physical activity significantly decreases. AIM To systematically review and conduct a meta-analysis on the effects of exercise rehabilitation on the physical activity of lung cancer patients and determine the best implementation methods to provide clinical guidance. METHODS Literature was searched through multiple electronic databases. A random effects model was used to combine effect sizes through standardized mean difference (SMD). The Cochrane risk of bias tool was used to assess the quality of the literature, sensitivity analysis was used to ensure the robustness of the results, and Egger’s test was used to detect publication bias and asymmetry. RESULTS A total of 11 studies involving 541 patients were included in this study. The physical endurance, muscle function and cardiopulmonary function of non-small cell lung cancer (NSCLC) patients were evaluated. The overall effect size of the six-minute walk test (6MWT) was not statistically significant. However, subgroup analysis found that endurance significantly improved when exercise duration exceeded 0.5 hours (P ≤ 0.05). In terms of muscle function, the overall effect size was SMD = 0.619. Subgroup analysis showed that strength training, respiratory training, and cross-training (XT) significantly improved muscle function. Exercise rehabilitation significantly enhanced cardiopulmonary endurance (SMD = 0.856, P = 0.002), and the effect was better when the single exercise duration was more than 1 hour, age was over 65 years, and the intervention period was more than 3 months. CONCLUSION Exercise rehabilitation effectively improved muscle function in NSCLC patients, especially strength training, respiratory training, and cross-training. Cardiopulmonary function also showed improvement, particularly when exercise duration exceeded 1 hour, age was ≥ 65 years, and the intervention period was more than 3 months. A single exercise duration of more than 0.5 hours can enhance patients’ physical endurance. Appropriately increasing exercise duration and selecting suitable exercise forms can effectively improve the physical activity of NSCLC patients.