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Exercise Training in Patients With Non-Small Cell Lung Cancer During In-Hospital Chemotherapy Treatment: A RANDOMIZED
Anna Rutkowska1, Dariusz Jastrzebski, Sebastian Rutkowski
1Institute of Physiotherapy, Department of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland (Drs Rutkowska, Rutkowski, and Szczegielniak); School of Medicine with the Division of Dentistry, Department of Lung Diseases and Tuberculosis, Medical University of Silesia, Zabrze, Poland (Drs Jastrzebski and Ziora); Department of Physiology and Medicine of Sport (Dr Żebrowska) and Department of Individual Sport (Dr Stanula), Academy of Physical Education, Katowice, Poland; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California (Dr Casaburi).
Purpose:
The aim of this study was to perform a randomized trial to assess the impact of exercise training in patients with non-small cell lung cancer during chemotherapy on several outcomes in comparison to a control group (CG).
Methods:
The exercise training group (ETG) consisted of 20 patients and the CG consisted of 10 patients. In the ETG, a 4-wk in-hospital exercise training program was performed in 2-wk cycles interspersed with consecutive rounds of chemotherapy with cytostatic drugs. The exercise training program was individualized and included warm-up, respiratory muscle exercise, training on a cycle ergometer or treadmill, and Nordic walking. CG participants were assessed before and after 6 wk of chemotherapy alone.
Results:
Comparing pre- and post-intervention values, the ETG demonstrated an increase in 6-min walk distance (486 ± 92 vs 531 ± 103 m, P = .01). In a battery of physical performance tests: Up and Go Test (6.3 ± 1.0 vs 6.0 ± 1.1 sec, P = .01); chair stand (13.3 ± 2.8 vs 14.3 ± 3.4 repetitions, P = .001); and arm curl (18.4 ± 3.1 vs 20.4 ± 3.5 repetitions, P = .001) all improved significantly. Spirometry values also improved: FEV1 % predicted (76 ± 16 vs 84 ± 15, P = .01), FVC % predicted (87 ± 14 vs 95 ± 13, P = .01), and FEV1/FVC (73 ± 13% vs 76 ± 12%, P = .04). The exercise training was well tolerated, without any adverse events due to exercise. There were no significant improvements in the CG.
Conclusions:
This study suggests that planned, individualized, and supervised exercise programs in patients with advanced lung cancer during chemotherapy are a practical and beneficial intervention for enhancing mobility and physical fitness.
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