Home-Based Program Enhances Exercise Capacity and Quality of Life After Lung Cancer Surgery: JAMA

This study was an assessment of the physical function and exercise capacity through improving quality of life in lung cancer surgery rehabilitation through a physiotherapist-led consultation during a home-based exercise and self-management program in patients.

The trial enrolled 116 patients undergoing surgery for non–small cell lung cancer between November 2017 and July 2023 at tertiary hospitals in Australia. Participants (mean age 66.4 years; 58.6% women) were randomized into two groups:

• Intervention group (58 patients): Received a 3-month home-based exercise and self-management program, supported by weekly physiotherapist-led telephone consultations.

• Control group (58 patients): Received standard postoperative care.

The primary outcome was self-reported physical functioning measured using the European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) at 3 months. Secondary outcomes included objective measures of physical function, exercise capacity (6-minute walk distance), and patient-reported quality of life. Follow-up assessments were conducted at 3, 6, and 12 months.

Key Findings

Primary Outcome:

• At 3 months, no clinically significant differences existed in self-reported physical functioning between the intervention and control groups (mean score: 77.3 vs. 76.3; mean difference, 1.0 point [95% CI, −6.0 to 8.0]).

Secondary Outcomes at 3 Months:

• Exercise capacity: Intervention group had a greater 6-minute walk distance (mean difference, 39.7 m [95% CI, 6.8-72.6 m]).

• Global quality of life: Scores higher in the intervention group (mean difference, 7.1 points [95% CI, 0.4-13.8 points]).

• Exercise self-efficacy: Improved significantly in the intervention group (mean difference, 16.0 points [95% CI, 7.0-24.9 points]).

Secondary Outcomes at 6 Months:

• Physical function: The scores of the Short Physical Performance Battery were higher in the intervention group (mean difference, 0.8 points [95% CI, 0.1-1.6 points]).

• Exercise capacity: Significant increase in 6-minute walk distance (mean difference, 50.9 m [95% CI, 6.7-95.1 m]).

• Exercise self-efficacy: The intervention group maintained its advantage (mean difference, 10.1 points [95% CI, 1.9-18.2 points]).

• There was one minor adverse event and no serious adverse events, thus demonstrating the safety of the program.

Patients following postoperative lung cancer surgery received benefit from an at-home, aftercare-based, exercise and self-management program based on an earlier randomized controlled exercise in trials. Improving exercise capacity as well as physical functions and quality of life, no potential benefit to these patients from increased self-reported improvement in physical functioning was reported based on a related randomized trial exercise.

Reference:

Granger CL, Edbrooke L, Antippa P, et al. Home-Based Exercise and Self-Management After Lung Cancer Resection: A Randomized Clinical Trial. JAMA Netw Open. 2024;7(12):e2447325. doi:10.1001/jamanetworkopen.2024.47325