Preoperative high-intensity interval training is effective and safe in deconditioned patients with lung cancer: A randomized clinical trial

The outcome of surgery in deconditioned patients can be improved through prehabilitation. This study examined the effect of prehabilitation in patients diagnosed with lung cancer. Candidates for lung cancer resection were assigned to high-intensity interval training (n = 74) or usual care (n = 77). Cardiopulmonary exercise testing and 6-min walk test were performed before and after training. High-intensity interval training consisted of 2-3-weekly, 2 × 10-min series of cycling at peak power, measured with cardiopulmonary exercise testing prior to training, with a 15-s on-off duty cycle, preceded by a 5-min warm-up and followed by a 5-min cool-down. Work-rate, heart-rate, saturation, dyspnoea and leg effort were monitored. Waiting time (median 25 days) allowed a median of 8 high-intensity interval training sessions to be performed. Adherence to mean high-intensity interval training was 87% (18%) (mean (standard deviation; SD)). High-intensity interval training power increased (23 watt, 95% confidence interval (95% CI): 20-26 watt), as did heart rate (14 bpm, 95% CI 11-16 bpm). Resting heart rate (-6 bpm, 95% CI -4 to -7 bpm) and heart rate 1 min post-cool-down decreased (-5 bpm, 95% CI -4 to -7 bpm). Aerobic capacity increased after high-intensity interval training (14%, 95% CI 3-26%), as did peak power output (median 7%, 95% CI 2-13%), but not after usual care. Six-min walk test score increased after high-intensity interval training (median 20%, 95% CI 14-26%), but not after usual care. Short-term high-intensity interval training is feasible in deconditioned patients and increases cardio-respiratory fitness and walking capacity.