Prehabilitation in lung cancer patients undergoing lung resection surgery (Fit4LungNeo): study protocol

Lung resection is the gold standard and the most effective curative treatment for lung cancer, especially in early-stage non-small cell lung cancer, improving long-term survival and quality of life. The growing body of evidence from randomized controlled trials supports the efficacy of prehabilitation in reducing both the incidence and severity of postoperative pulmonary complications and shortening the length of hospital stay.

The general objective is to compare the effects of a single education session with different prehabilitation programs in patients undergoing lung resection surgery.

Two hundred lung cancer patients who are going to be submitted to a lung resection surgery will be randomized into: (1) Inspiratory Muscle Training Group (n = 50), Expiratory Muscle Training Group (n = 50), Global Exercise Training Group (n = 50), and Control Group (n = 50). All patients will receive a single session in-person education session and written information regarding healthy habits to follow before, during, and after hospital discharge, and those from the IMT-G, EMT-G, and GET-G will start their 2-week prehabilitation interventions at ULS São João. Patients will be evaluated at baseline, after completing the prehabilitation program (post-intervention assessment), and 30 days post-discharge (follow-up assessment).

Despite diverse intervention strategies, prehabilitation consistently proves effective in bolstering patients' functional capacity. It may also help strengthen the respiratory muscles, which in turn affect lung function and cough effectiveness after thoracic surgery. This randomized trial has been designed to compare different prehabilitation programs and analyze their inherent costs.