Combined aerobic exercise and high-intensity respiratory muscle training in patients surgically treated for non-small cell lung cancer: A pilot randomized clinical trial

Monique Messaggi-Sartor, Ester Marco, Elisabeth Martínez-Téllez, Alberto Rodriguez-Fuster, Carolina Palomares, Sandra Chiarella, Josep M. Muniesa, Mauricio Orozco-Levi, Esther Barreiro, Maria R. Güell

    Research output: Contribution to journalArticleResearch

    10 Citations (Scopus)

    Abstract

    © 2018 EDIZIONI MINERVA MEDICA BACKGROUND: Lung resection surgery further decreases exercise capacity and negatively affects respiratory muscle function in patients with non-small cell lung cancer (NSCLC). The best design for exercise interventions in these patients has not been determined yet. AIM: To assess the impact of aerobic exercise and high-intensity respiratory muscle training on patient outcomes following lung cancer resection surgery. DESIGN: Prospective, single-blind, pilot randomized controlled trial. SETTING: Outpatient cardiopulmonary rehabilitation unit of two university hospitals. POPULATION: Thirty-seven patients with NSCLC after tumor resection. METHODS: Patients were randomly assigned to exercise training or usual post-operative care. The training program consisted of aerobic exercises and high-intensity respiratory muscle training (24 supervised sessions, 3 per week, 8 weeks). Primary outcome was exercise capacity assessed with peak oxygen uptake (VO 2peak ) during cardiopulmonary exercise test. Secondary outcomes included changes in respiratory muscle strength, levels of serum insulin growth factor I (IGF-I) and IGF binding protein 3 (IGFBP-3), and quality of life assessed with the European Organization for Research and Treatment of Cancer (EORTC QLQ-C30) questionnaire. RESULTS: The 8-week training program was associated with significant improvement in VO 2peak (2.13 mL/Kg/min [95%CI 0.06 to 4.20]), maximal inspiratory and expiratory pressures (18.96 cmH 2 O [95% CI 2.7 to 24.1] and 18.58 cmH 2 O [95% CI 4.0 to 33.1], respectively) and IGFBP-3 (0.61 µg/mL [%95 CI 0.1 to 1.12]). No significant differences were observed in the EORTC QLQ-C30. CONCLUSIONS: An 8-week exercise program consisting of aerobic exercise and high-intensity respiratory muscle training improved exercise capacity, respiratory muscle strength, and serum IGFBP-3 levels in NSCLC patients after lung resection. There was no impact on the other outcomes assessed. CLINICAL REHABILITATION IMPACT: A combination of aerobic exercise and respiratory muscle training could be included in the rehabilitation program of deconditioned patients with NSCLC after lung resection surgery.
    Original languageEnglish
    Pages (from-to)113-122
    JournalEuropean Journal of Physical and Rehabilitation Medicine
    Volume55
    DOIs
    Publication statusPublished - 1 Feb 2019

    Keywords

    • Breathing exercises
    • Cardiorespiratory fitness
    • Lung neoplasms
    • Rehabilitation

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