Short-Term Preoperative High-Intensity Interval Training in Patients Awaiting Lung Cancer Surgery: A Randomized Controlled Trial

Licker, Marc; Karenovicŝ, Wolfram; Diaper, John; Frésard, Isabelle; Triponez, Frédéric; Ellenberger, Christoph; Schorer, Raoul; Kayser, Bengt; Bridevaux, Pierre‐Olivier

doi:10.1016/j.jtho.2016.09.125

Cited by 191 publications

(262 citation statements)

References 43 publications

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“…Interventions were implemented 1 to 2 weeks (n = 9), 1 to 5 days (n = 2), 1 month (n = 2), 3 weeks (n = 1) and the day preceding treatment (n = 1). Three studies did not specify the time frame of intervention implementation prior to treatment [16][17][18]. Standard care varied according to individual institutions whereby verbal or written instructions were given [15,[19][20][21], physical activity was delivered in the rehabilitation setting post-treatment [22,23], generic risk management and active mobilisation was given [18] or fast-track surgery was implemented [24].…”

Section: Resultsmentioning

confidence: 99%

“…Standard care varied according to individual institutions whereby verbal or written instructions were given [15,[19][20][21], physical activity was delivered in the rehabilitation setting post-treatment [22,23], generic risk management and active mobilisation was given [18] or fast-track surgery was implemented [24]. Five studies delivered interventions in the pre-treatment period only [12,17,18,[25][26][27]; the remaining studies continued the interventions during or after treatment. In total, 22 interventions were compared to a usual care control group.…”

Section: Resultsmentioning

confidence: 99%

“…Results from individual studies that could not be included in the meta-analysis found that the incidence of respiratory complications was lower among patients who participated in HIIT compared to usual care. There were no significant between-group differences in cardiovascular and surgical complications, wound infection or renal dysfunction as a result of HIIT [18]. Regarding specific complications, a control group in one study [22] experienced fever (n = 2), atelectasis (n = 1), pneumonia (n = 1) and haemorrhagic drainage (n = 1), whereas fever was experienced by one patient in the intervention group.…”

Section: Lung Cancer Pre-surgical Exercise Versus Usual Carementioning

confidence: 90%

“…Seven studies investigated the effects of pre-surgical exercise compared to usual care on health service utilisation [12,17,18,22], post-operative complications [12,17,18,22], cardiopulmonary [12,17,18,22,25], QoL [17] and psychological [26] outcomes among lung cancer patients. Each study was rated as having a high risk of bias.…”

Section: Lung Cancer Pre-surgical Exercise Versus Usual Carementioning

confidence: 99%

“…Findings from individual studies on other health service utilisation outcomes reported a reduction in the number of days spent in hospital post-operation (pulmonary prehabilitation [mean = 4.4] compared to the usual care group [mean = 6.9], p = 0.010) [17]. Furthermore, high-intensity interval training (HIIT) led to a significant reduction in hours spent in recovery from anaesthesia (median = 25 versus 17, p < 0001) compared to patients who did not participate in HIIT; however, there was no significant between-group difference for days spent in hospital [18]. There were no significant between-group differences for mean number of intensive care unit hours or mean ventilation hours as a result of pulmonary exercise [12].…”

Section: Lung Cancer Pre-surgical Exercise Versus Usual Carementioning

confidence: 99%

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An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

2017

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Purpose The purpose of the study is to systematically review and synthesise randomised controlled trials investigating the effectiveness of prehabilitation compared to usual care for newly diagnosed, adult-onset cancer patients. Methods MEDLINE, EMBASE, PsycINFO, CINAHL and SSCI were searched up to April 2017. Studies were included if disease-related, treatment-related, patient-reported and health service utilisation outcomes were assessed. Two reviewers independently reviewed and appraised the risk of bias of each study. Results Eighteen studies were included. Interventions comprised one or more of the following components: psychological support, education and exercise. Meta-analyses found that pelvic floor muscle training (PFMT) significantly increased odds of continence at 3 months (OR = 3.29, 95% CI = 1.57-6.91), but did not significantly reduce daily pad use at 6 months post-surgery Mean Difference (MD)= ( = − 0.96, 95% CI = − 2.04-0.12) for prostate cancer patients. Although quality of life improved due to PFMT, functional ability or distress did not. Further meta-analyses indicated that presurgical exercise significantly reduced length of hospital stay (MD = − 4.18, 95% CI = − 5.43-− 2.93) and significantly lowered odds of post-surgery complications (OR = 0.25, 95% CI = 0.10-0.66) for lung cancer patients. Psychology-based prehabilitation significantly improved mood, physical wellbeing and immune function for prostate cancer patients and improved fatigue and psychological outcomes and a trend for better quality of life among breast cancer patients. Risk of bias was high for most studies. Conclusions Prehabilitation appears to benefit cancer patients. Rigorous trials are needed to investigate the effectiveness of prehabilitation among other cancer sites and other related effects. The cost-effectiveness of prehabilitation remains unanswered. Implications for cancer survivors Providing interventions earlier in the care pathway may lead to better outcomes for patients during survivorship.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Lung Cancer Pre-surgical Exercise Versus Usual Carementioning

confidence: 90%

Section: Lung Cancer Pre-surgical Exercise Versus Usual Carementioning

confidence: 99%

Section: Lung Cancer Pre-surgical Exercise Versus Usual Carementioning

confidence: 99%

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An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

2017

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Association of Preoperative High-Intensity Interval Training With Cardiorespiratory Fitness and Postoperative Outcomes Among Adults Undergoing Major Surgery

et al. 2023

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ImportancePreoperative high-intensity interval training (HIIT) is associated with improved cardiorespiratory fitness (CRF) and may improve surgical outcomes.ObjectiveTo summarize data from studies comparing the association of preoperative HIIT vs standard hospital care with preoperative CRF and postoperative outcomes.Data SourcesData sources included Medline, Embase, Cochrane Central Register of Controlled Trials Library, and Scopus databases with no language constraints, including abstracts and articles published before May 2023.Study SelectionThe databases were searched for randomized clinical trials and prospective cohort studies with HIIT protocols in adult patients undergoing major surgery. Thirty-four of 589 screened studies met initial selection criteria.Data Extraction and SynthesisA meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data were extracted by multiple independent observers and pooled in a random-effects model.Main Outcomes and MeasuresThe primary outcome was change in CRF, as measured by either peak oxygen consumption (V̇o2 peak) or 6-Minute Walk Test (6MWT) distance. Secondary outcomes included postoperative complications; hospital length of stay (LOS); and changes in quality of life, anaerobic threshold, and peak power output.ResultsTwelve eligible studies including 832 patients were identified. Pooled results indicated several positive associations for HIIT when compared with standard care either on CRF (V̇o2 peak, 6MWT, anaerobic threshold, or peak power output) or postoperative outcomes (complications, LOS, quality of life), although there was significant heterogeneity in study results. In 8 studies including 627 patients, there was moderate-quality evidence of significant improvement in V̇o2 peak (cumulative mean difference, 2.59 mL/kg/min; 95% CI, 1.52-3.65 mL/kg/min; P &lt; .001). In 8 studies including 770 patients, there was moderate-quality evidence of a significant reduction in complications (odds ratio, 0.44; 95% CI, 0.32-0.60; P &lt; .001). There was no evidence that HIIT differed from standard care in hospital LOS (cumulative mean difference, −3.06 days; 95% CI, −6.41 to 0.29 days; P = .07). The analysis showed a high degree of heterogeneity in study outcomes and an overall low risk of bias.Conclusions and RelevanceThe results of this meta-analysis suggest that preoperative HIIT may be beneficial for surgical populations through the improvement of exercise capacity and reduced postoperative complications. These findings support including HIIT in prehabilitation programs before major surgery. The high degree of heterogeneity in both exercise protocols and study results supports the need for further prospective, well-designed studies.

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Preoperative exercise training for people with non-small cell lung cancer

Granger

Cavalheri

2022

Cochrane Database of Systematic Reviews

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Short-Term Preoperative High-Intensity Interval Training in Patients Awaiting Lung Cancer Surgery: A Randomized Controlled Trial

Abstract: In this randomized controlled trial, preoperative HIIT resulted in significant improvement in aerobic performances but failed to reduce early complications after lung cancer resection.

Cited by 191 publications

References 43 publications

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

An international review and meta-analysis of prehabilitation compared to usual care for cancer patients

Association of Preoperative High-Intensity Interval Training With Cardiorespiratory Fitness and Postoperative Outcomes Among Adults Undergoing Major Surgery

Preoperative exercise training for people with non-small cell lung cancer

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