TOPLINE:
Implementing a home-based exercise program alongside management strategies did not improve patients’ self-reported physical function after lung cancer surgery but did enhance exercise capacity, health-related quality of life, and exercise self-efficacy, a new study revealed.
METHODOLOGY:
- Lung cancer survivors face long-term physical challenges post-surgery. Postoperative exercise programs have largely been evaluated in a supervised hospital setting, but such programs lack widespread implementation. Home-based exercise programs offer a promising alternative.
- In the current analysis, researchers assessed 116 patients (mean age, 66.4 years) who underwent surgery for non–small cell lung cancer. Half were randomly assigned to a 3-month home-based exercise program (n = 58) and half to usual care (standard medical care and monitoring).
- The home-based program combined physical exercise, management techniques, and behavioral support. Participants completed the initial session in person before hospital discharge, followed by weekly physiotherapist-led telephone consultations for 12 sessions. Patients also had a diary to track daily compliance and monitor steps at home.
- The primary outcome was self-reported physical function, assessed using the European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire, at 3 months; secondary outcomes included exercise capacity, quality of life, and exercise self-efficacy (barriers to exercising).
- Overall, 88.8% of patients completed follow-up assessments at 3 months and 81.9% completed them only at 6 and 12 months.
TAKEAWAY:
- At 3 months postoperatively, self-reported physical function was not significantly different between the home-based exercise group and the control group (mean difference, 1 point; 95% CI, −6 to 8). There were no statistically significant differences between the groups at 6 or 12 months either.
- However, compared with those who received usual care, participants who underwent the home-based exercise program reported significantly improved exercise capacity at 3 months — mean 6-minute walk distance of 484.6 m vs 425.7 m — and at 6 months — mean 6-minute walk distance of 495 m vs 412 m.
- Global health-related quality of life improved significantly at 3 months (mean difference, 7.1 points). At 6 months, objectively measured physical function measures improved (mean difference, 0.8 points). Patients in the exercise intervention group also reported fewer barriers to exercising at both 3 months and 6 months.
- Patient safety was maintained throughout the program, with only one minor adverse event reported and no serious adverse events.
IN PRACTICE:
Although the primary outcome was not met, this “study provides high-quality evidence that home-based physical activity after lung cancer surgery improved multiple clinically relevant outcomes: Exercise capacity, [health-related quality of life], and self-efficacy at 3 and 6 months,” outside experts said in an accompanying editorial. “Patients and physicians should strongly consider recommending (or providing) home-based physical activity interventions after lung cancer surgery.”
The study authors agreed, noting that “implementation of this program into lung cancer care should be considered.”
SOURCE:
This study, led by Catherine L. Granger, PhD, Department of Physiotherapy, The University of Melbourne, Parkville, Australia, was published online in JAMA Network Open, alongside an editorial.
LIMITATIONS:
Potential biases included exclusion of non-English speakers and unblinding of participants and physiotherapists to group allocation. The sample population was already physically active at baseline, and the study was underpowered to detect differences in secondary outcomes. With about 12% of participants referred to pulmonary rehabilitation across both groups, the effectiveness of this study intervention vs supervised center-based exercise training remains unclear.
DISCLOSURES:
This study was funded by the Victorian Cancer Agency, Cancer Council Victoria, and The University of Melbourne. The authors reported no relevant conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.