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Pulmonary Rehabilitation Programme for Patients Undergoing Curative Lung Cancer Surgery

Bradley, A. and Marshall, A. and Stonehewer, L. and Reaper, L. and Parker, K. and Bevan-Smith, Elaine and Jordan, C. and Gillies, J. and Agostini, P. and Bishop, E. and Kalkat, M. and Steyn, R. and Rajesh, P. (2013) Pulmonary Rehabilitation Programme for Patients Undergoing Curative Lung Cancer Surgery. European Journal of Cardio-Thoracic, 44 (4). e266-e271. ISSN Print: 1010-7940 Online: 1873-743X

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Abstract

OBJECTIVES The aim of the study was to develop a multistranded pragmatic rehabilitation programme for operable lung cancer patients, that looks into feasibility, process indicators, outcome measures, local adaptability, compliance and potential cost benefit. METHODS An outpatient-based complex intervention, rehabilitation for operated lung cancer (ROC) programme, was developed to optimize physical status, prepare for the inpatient journey and support through recovery after surgery. It includes exercise classes, smoking cessation, dietary advice and patient education and was tested in an enriched cohort study within a regional thoracic unit over 18 months. RESULTS A multistranded pragmatic rehabilitation programme pre- and post-surgery is feasible. Fifty-eight patients received the intervention and 305 received standard care. Both groups were matched for age, lung function comorbidity and type of surgery. Patients in the intervention group attended exercise classes twice a week until surgery, which was not delayed. Patients attended four sessions presurgery (range 1–15), resulting in an improvement of 20 m (range −73–195, P = 0.001) in a 6-min walk test and 0.66 l in forced expiratory volume in 1 s (range −1.85 from 1.11, P = 0.009) from baseline to presurgery. Fifty-four percentage of smokers in the intervention group stopped smoking. Sixteen percentage of patients were identified as being at risk of malnourishment and received nutritional intervention. There was a trend in patients in the intervention group towards experiencing fewer postoperative pulmonary complications than those in the non-intervention group (9 vs 16%, respectively, P = 0.21) and fewer readmissions to hospital because of complications (5 vs 14% respectively, P = 0.12). CONCLUSION Chronic obstructive pulmonary disease-type pulmonary rehabilitation before and after lung cancer surgery is viable, and preliminary results suggest improvement in physical measures. A multicentre, randomized controlled trial is warranted to confirm clinical efficacy.

Item Type: Article
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Uncontrolled Keywords: rehabilitation programme, operable lung cancer patients, COPD, lung cancer surgery, thoracic surgery, post operative pulmonary complications
Subjects: R Medicine > R Medicine (General)
Divisions: Academic Departments > Institute of Health and Society
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Depositing User: Elaine Bevan-Smith
Date Deposited: 04 Nov 2018 14:44
Last Modified: 05 Nov 2018 13:44
URI: https://eprints.worc.ac.uk/id/eprint/7207

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