The effect of a post-operative mobility and strengthening programme on quality of life, exercise tolerance and muscle strength after thoracotomy for non-small lung cancer

Background: Deterioration in exercise tolerance, muscle strength and impairment in quality of life (Qol) are common consequences of lung resection. This study uses these measures to evaluate the efficacy of administering an additional exercise and strength training programme after lung resection. Methods: 53 (28 male) patients attending thoracotomy were recruited into the study: mean age (range) 64 (32 to 82) years; mean pack years (M±SD) 31.9 ± 26.8; BMI 25.6 ±4.2; FEV1 2.0 ± 0.7 litres (I). Patients were randomised to control (usual care) or intervention (twice daily training plus usual care). Physícal training was provided twice daily (for 30 minutes maximum) for 5 days post-operatively and involved marching on the spot, walking, and cycling on a recumbent bike and seated quadriceps raises; Pre-and 5 day post-operative assessments consisted of quadriceps strength using magnetic stimulation superimposed twitch and exercise tolerance using 6 minute walking distance (6MWD). Qol was assessed pre-operatively only using European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QlQ) C30 with lC13. At 12 weeks post-operatively both groups were reassessed for quadriceps strength, exercise tolerance and QoL. The intervention group received additional monthly home visits and weekly telephone calls for the 12 weeks; the control group only received the monthly telephone calls. length of stay (lOS) and post-operative complications (PaC's) were recorded, Unpaired t-tests were used to evaluate difference between groups, p