Exercise intervention for patients surgically treated for Non-Small Cell Lung Cancer (NSCLC): A systematic review

Crandall, Kathryn, Maguire, Roma, Campbell, Anna and Kearney, Nora (2014) Exercise intervention for patients surgically treated for Non-Small Cell Lung Cancer (NSCLC): A systematic review. Surgical Oncology, 23 (1). pp. 17-30. ISSN 0960-7404

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Official URL: http://dx.doi.org/10.1016/j.suronc.2014.01.001

Abstract

Background
Surgery remains the best curative option for appropriately selected patients with lung cancer. Evidence suggests that improving cardiovascular fitness and functional capacity can accelerate post-surgery recovery and reduce mortality. However, the effect of exercise intervention for patients surgically treated for Non-Small Cell Lung Cancer [NCSLC] has not been fully examined.

Purpose
This review examines the literature regarding exercise intervention for patients who are surgically treated for NSCLC focussing on three key areas: methodological quality, intervention design (e.g. duration, frequency, type) and outcomes measured.

Methods
A search of Medline, EMBASE, CINAHL and PsychINFO was undertaken. Randomised Controlled Trials [RCTs] and non-RCTs including exercise training pre or post lung cancer resection were included. Descriptive characteristics were extracted and methodological quality assessed using Downs and Black appraisal checklist.

Results
Twenty studies (eight RCT's) were included: nine pre-surgical, nine post-surgical and two pre to post-surgical. The quality of evidence is questionable with many limitations (e.g. small samples, inadequate allocation concealment and a lack of clear reporting on timing, adverse events and follow-up). Regarding design of exercise intervention and outcomes measured, there was much variation between studies producing a disparate set of data. An optimal programme is still to be determined; however, suggestions are made relating to type of exercise (i.e. mixing aerobic, resistance and breathing exercises). Preliminary work from this review suggests that exercise intervention compared with usual care both pre and post-surgery is associated with improved cardiopulmonary exercise capacity, increased muscle strength and reduced fatigue, post-operative complications and hospital length of stay. Results concerning pulmonary function, quality of life, and blood gas analysis were variable and inconsistent.

Conclusion
In order to implement exercise intervention appropriate for patients surgically treated for NCSLC, more high quality randomised controlled trials are required and more work concerning feasibility, acceptability and effectiveness of specific interventions on outcomes is warranted.

Item Type: Article
Subjects: B900 Others in Subjects allied to Medicine
Department: Faculties > Health and Life Sciences > Nursing, Midwifery and Health
Depositing User: Becky Skoyles
Date Deposited: 08 Nov 2018 16:18
Last Modified: 11 Oct 2019 18:45
URI: http://nrl.northumbria.ac.uk/id/eprint/36572

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