Exercise training undertaken by people within 12 months of lung resection for non‐small cell lung cancer
Background Decreased exercise capacity and health‐related quality of life (HRQoL) are common in people following lung resection for non‐small cell lung cancer (NSCLC). Exercise training has been demonstrated to confer gains in exercise capacity and HRQoL for people with a range of chronic conditions...
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| Veröffentlicht in: | Cochrane database of systematic reviews 2019-06, Vol.2019 (6), p.CD009955-CD009955 |
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| creator | Cavalheri, Vinicius Burtin, Chris Formico, Vittoria R Nonoyama, Mika L Jenkins, Sue Spruit, Martijn A Hill, Kylie Cavalheri, Vinicius |
| description | Background
Decreased exercise capacity and health‐related quality of life (HRQoL) are common in people following lung resection for non‐small cell lung cancer (NSCLC). Exercise training has been demonstrated to confer gains in exercise capacity and HRQoL for people with a range of chronic conditions, including chronic obstructive pulmonary disease and heart failure, as well as in people with prostate and breast cancer. A programme of exercise training may also confer gains in these outcomes for people following lung resection for NSCLC. This systematic review updates our 2013 systematic review.
Objectives
The primary aim of this review was to determine the effects of exercise training on exercise capacity and adverse events in people following lung resection (with or without chemotherapy) for NSCLC. The secondary aims were to determine the effects of exercise training on other outcomes such as HRQoL, force‐generating capacity of peripheral muscles, pressure‐generating capacity of the respiratory muscles, dyspnoea and fatigue, feelings of anxiety and depression, lung function, and mortality.
Search methods
We searched for additional randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 2 of 12), MEDLINE (via PubMed) (2013 to February 2019), Embase (via Ovid) (2013 to February 2019), SciELO (The Scientific Electronic Library Online) (2013 to February 2019), and PEDro (Physiotherapy Evidence Database) (2013 to February 2019).
Selection criteria
We included RCTs in which participants with NSCLC who underwent lung resection were allocated to receive either exercise training, which included aerobic exercise, resistance exercise, or a combination of both, or no exercise training.
Data collection and analysis
Two review authors screened the studies and identified those eligible for inclusion. We used either postintervention values (with their respective standard deviation (SD)) or mean changes (with their respective SD) in the meta‐analyses that reported results as mean difference (MD). In meta‐analyses that reported results as standardised mean difference (SMD), we placed studies that reported postintervention values and those that reported mean changes in separate subgroups. We assessed the certainty of evidence for each outcome by downgrading or upgrading the evidence according to GRADE criteria.
Main results
Along with the three RCTs included in the original version of this review |
| doi_str_mv | 10.1002/14651858.CD009955.pub3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6571512</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2250602815</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5393-8dddac868d3ec10779c7c2340b7e4fbd923bd8b3e740782bb743ae34380635d83</originalsourceid><addsrcrecordid>eNqFkc1u1DAUhS0Eoj_wCpWXbGbwTxw7GySYthSpEhtYW45903FJ7MFOWmbHI_QZ-yR1mE5V2LCxLd3vnnOvD0InlCwpIew9rWpBlVDL1SkhTSPEcjO1_AU6nAuLufLy2fsAHeV8TQivGyZfowNOGakq3hyi67NfkKzPgMdkfPDhCk_BQRrNDwi43eINxE0P-NaPax8wZXiIYVxnHDvcT4VOkMGOPgbcxYRDDPe_7_Jg-h5bKMcfxppgIb1BrzrTZ3j7eB-j7-dn31YXi8uvn7-sPl4urOANXyjnnLGqVo6DpUTKxkrLeEVaCVXXuobx1qmWg6yIVKxtZcUN8IorUnPhFD9GH3a65UcGcBZCWa3Xm-QHk7Y6Gq__rgS_1lfxRtdCUkFZEXj3KJDizwnyqAef521MgDhlzZggNWGKioLWO9SmmHOC7smGEj0HpfdB6X1QszkvjSfPh3xq2ydTgE874Nb3sNU22nUq_v_R_cflAUmApo4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2250602815</pqid></control><display><type>article</type><title>Exercise training undertaken by people within 12 months of lung resection for non‐small cell lung cancer</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Cochrane Library</source><source>Alma/SFX Local Collection</source><creator>Cavalheri, Vinicius ; Burtin, Chris ; Formico, Vittoria R ; Nonoyama, Mika L ; Jenkins, Sue ; Spruit, Martijn A ; Hill, Kylie ; Cavalheri, Vinicius</creator><creatorcontrib>Cavalheri, Vinicius ; Burtin, Chris ; Formico, Vittoria R ; Nonoyama, Mika L ; Jenkins, Sue ; Spruit, Martijn A ; Hill, Kylie ; Cavalheri, Vinicius</creatorcontrib><description>Background
Decreased exercise capacity and health‐related quality of life (HRQoL) are common in people following lung resection for non‐small cell lung cancer (NSCLC). Exercise training has been demonstrated to confer gains in exercise capacity and HRQoL for people with a range of chronic conditions, including chronic obstructive pulmonary disease and heart failure, as well as in people with prostate and breast cancer. A programme of exercise training may also confer gains in these outcomes for people following lung resection for NSCLC. This systematic review updates our 2013 systematic review.
Objectives
The primary aim of this review was to determine the effects of exercise training on exercise capacity and adverse events in people following lung resection (with or without chemotherapy) for NSCLC. The secondary aims were to determine the effects of exercise training on other outcomes such as HRQoL, force‐generating capacity of peripheral muscles, pressure‐generating capacity of the respiratory muscles, dyspnoea and fatigue, feelings of anxiety and depression, lung function, and mortality.
Search methods
We searched for additional randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 2 of 12), MEDLINE (via PubMed) (2013 to February 2019), Embase (via Ovid) (2013 to February 2019), SciELO (The Scientific Electronic Library Online) (2013 to February 2019), and PEDro (Physiotherapy Evidence Database) (2013 to February 2019).
Selection criteria
We included RCTs in which participants with NSCLC who underwent lung resection were allocated to receive either exercise training, which included aerobic exercise, resistance exercise, or a combination of both, or no exercise training.
Data collection and analysis
Two review authors screened the studies and identified those eligible for inclusion. We used either postintervention values (with their respective standard deviation (SD)) or mean changes (with their respective SD) in the meta‐analyses that reported results as mean difference (MD). In meta‐analyses that reported results as standardised mean difference (SMD), we placed studies that reported postintervention values and those that reported mean changes in separate subgroups. We assessed the certainty of evidence for each outcome by downgrading or upgrading the evidence according to GRADE criteria.
Main results
Along with the three RCTs included in the original version of this review (2013), we identified an additional five RCTs in this update, resulting in a total of eight RCTs involving 450 participants (180 (40%) females). The risk of selection bias in the included studies was low and the risk of performance bias high. Six studies explored the effects of combined aerobic and resistance training; one explored the effects of combined aerobic and inspiratory muscle training; and one explored the effects of combined aerobic, resistance, inspiratory muscle training and balance training. On completion of the intervention period, compared to the control group, exercise capacity expressed as the peak rate of oxygen uptake (VO2peak) and six‐minute walk distance (6MWD) was greater in the intervention group (VO2peak: MD 2.97 mL/kg/min, 95% confidence interval (CI) 1.93 to 4.02 mL/kg/min, 4 studies, 135 participants, moderate‐certainty evidence; 6MWD: MD 57 m, 95% CI 34 to 80 m, 5 studies, 182 participants, high‐certainty evidence). One adverse event (hip fracture) related to the intervention was reported in one of the included studies. The intervention group also achieved greater improvements in the physical component of general HRQoL (MD 5.0 points, 95% CI 2.3 to 7.7 points, 4 studies, 208 participants, low‐certainty evidence); improved force‐generating capacity of the quadriceps muscle (SMD 0.75, 95% CI 0.4 to 1.1, 4 studies, 133 participants, moderate‐certainty evidence); and less dyspnoea (SMD −0.43, 95% CI −0.81 to −0.05, 3 studies, 110 participants, very low‐certainty evidence). We observed uncertain effects on the mental component of general HRQoL, disease‐specific HRQoL, handgrip force, fatigue, and lung function. There were insufficient data to comment on the effect of exercise training on maximal inspiratory and expiratory pressures and feelings of anxiety and depression. Mortality was not reported in the included studies.
Authors' conclusions
Exercise training increased exercise capacity and quadriceps muscle force of people following lung resection for NSCLC. Our findings also suggest improvements on the physical component score of general HRQoL and decreased dyspnoea. This systematic review emphasises the importance of exercise training as part of the postoperative management of people with NSCLC.</description><identifier>ISSN: 1465-1858</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD009955.pub3</identifier><identifier>PMID: 31204439</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Breathing Exercises ; Cancer ; Carcinoma, Non-Small-Cell Lung - rehabilitation ; Carcinoma, Non-Small-Cell Lung - surgery ; Carcinoma, Non‐Small‐Cell Lung ; Complementary & alternative medicine ; Exercise Therapy ; Exercise Tolerance ; Exercise Tolerance - physiology ; Female ; Forced Expiratory Volume ; Forced Expiratory Volume - physiology ; Health Status ; Holistic/complementary/non‐invasive therapies ; Humans ; Lung ; Lung cancer ; Lung Neoplasms ; Lung Neoplasms - rehabilitation ; Lung Neoplasms - surgery ; Lungs & airways ; Male ; Medicine General & Introductory Medical Sciences ; Muscle Strength ; Muscle Strength - physiology ; Non‐small cell ; NSCLC ; Oxygen Consumption ; Postoperative Care ; Postoperative Care - methods ; Quadriceps Muscle ; Quadriceps Muscle - physiology ; Quality of Life ; Randomized Controlled Trials as Topic ; Resistance Training ; Time Factors ; Treatment</subject><ispartof>Cochrane database of systematic reviews, 2019-06, Vol.2019 (6), p.CD009955-CD009955</ispartof><rights>Copyright © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5393-8dddac868d3ec10779c7c2340b7e4fbd923bd8b3e740782bb743ae34380635d83</citedby><cites>FETCH-LOGICAL-c5393-8dddac868d3ec10779c7c2340b7e4fbd923bd8b3e740782bb743ae34380635d83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31204439$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cavalheri, Vinicius</creatorcontrib><creatorcontrib>Burtin, Chris</creatorcontrib><creatorcontrib>Formico, Vittoria R</creatorcontrib><creatorcontrib>Nonoyama, Mika L</creatorcontrib><creatorcontrib>Jenkins, Sue</creatorcontrib><creatorcontrib>Spruit, Martijn A</creatorcontrib><creatorcontrib>Hill, Kylie</creatorcontrib><creatorcontrib>Cavalheri, Vinicius</creatorcontrib><title>Exercise training undertaken by people within 12 months of lung resection for non‐small cell lung cancer</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
Decreased exercise capacity and health‐related quality of life (HRQoL) are common in people following lung resection for non‐small cell lung cancer (NSCLC). Exercise training has been demonstrated to confer gains in exercise capacity and HRQoL for people with a range of chronic conditions, including chronic obstructive pulmonary disease and heart failure, as well as in people with prostate and breast cancer. A programme of exercise training may also confer gains in these outcomes for people following lung resection for NSCLC. This systematic review updates our 2013 systematic review.
Objectives
The primary aim of this review was to determine the effects of exercise training on exercise capacity and adverse events in people following lung resection (with or without chemotherapy) for NSCLC. The secondary aims were to determine the effects of exercise training on other outcomes such as HRQoL, force‐generating capacity of peripheral muscles, pressure‐generating capacity of the respiratory muscles, dyspnoea and fatigue, feelings of anxiety and depression, lung function, and mortality.
Search methods
We searched for additional randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 2 of 12), MEDLINE (via PubMed) (2013 to February 2019), Embase (via Ovid) (2013 to February 2019), SciELO (The Scientific Electronic Library Online) (2013 to February 2019), and PEDro (Physiotherapy Evidence Database) (2013 to February 2019).
Selection criteria
We included RCTs in which participants with NSCLC who underwent lung resection were allocated to receive either exercise training, which included aerobic exercise, resistance exercise, or a combination of both, or no exercise training.
Data collection and analysis
Two review authors screened the studies and identified those eligible for inclusion. We used either postintervention values (with their respective standard deviation (SD)) or mean changes (with their respective SD) in the meta‐analyses that reported results as mean difference (MD). In meta‐analyses that reported results as standardised mean difference (SMD), we placed studies that reported postintervention values and those that reported mean changes in separate subgroups. We assessed the certainty of evidence for each outcome by downgrading or upgrading the evidence according to GRADE criteria.
Main results
Along with the three RCTs included in the original version of this review (2013), we identified an additional five RCTs in this update, resulting in a total of eight RCTs involving 450 participants (180 (40%) females). The risk of selection bias in the included studies was low and the risk of performance bias high. Six studies explored the effects of combined aerobic and resistance training; one explored the effects of combined aerobic and inspiratory muscle training; and one explored the effects of combined aerobic, resistance, inspiratory muscle training and balance training. On completion of the intervention period, compared to the control group, exercise capacity expressed as the peak rate of oxygen uptake (VO2peak) and six‐minute walk distance (6MWD) was greater in the intervention group (VO2peak: MD 2.97 mL/kg/min, 95% confidence interval (CI) 1.93 to 4.02 mL/kg/min, 4 studies, 135 participants, moderate‐certainty evidence; 6MWD: MD 57 m, 95% CI 34 to 80 m, 5 studies, 182 participants, high‐certainty evidence). One adverse event (hip fracture) related to the intervention was reported in one of the included studies. The intervention group also achieved greater improvements in the physical component of general HRQoL (MD 5.0 points, 95% CI 2.3 to 7.7 points, 4 studies, 208 participants, low‐certainty evidence); improved force‐generating capacity of the quadriceps muscle (SMD 0.75, 95% CI 0.4 to 1.1, 4 studies, 133 participants, moderate‐certainty evidence); and less dyspnoea (SMD −0.43, 95% CI −0.81 to −0.05, 3 studies, 110 participants, very low‐certainty evidence). We observed uncertain effects on the mental component of general HRQoL, disease‐specific HRQoL, handgrip force, fatigue, and lung function. There were insufficient data to comment on the effect of exercise training on maximal inspiratory and expiratory pressures and feelings of anxiety and depression. Mortality was not reported in the included studies.
Authors' conclusions
Exercise training increased exercise capacity and quadriceps muscle force of people following lung resection for NSCLC. Our findings also suggest improvements on the physical component score of general HRQoL and decreased dyspnoea. This systematic review emphasises the importance of exercise training as part of the postoperative management of people with NSCLC.</description><subject>Breathing Exercises</subject><subject>Cancer</subject><subject>Carcinoma, Non-Small-Cell Lung - rehabilitation</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Carcinoma, Non‐Small‐Cell Lung</subject><subject>Complementary & alternative medicine</subject><subject>Exercise Therapy</subject><subject>Exercise Tolerance</subject><subject>Exercise Tolerance - physiology</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Forced Expiratory Volume - physiology</subject><subject>Health Status</subject><subject>Holistic/complementary/non‐invasive therapies</subject><subject>Humans</subject><subject>Lung</subject><subject>Lung cancer</subject><subject>Lung Neoplasms</subject><subject>Lung Neoplasms - rehabilitation</subject><subject>Lung Neoplasms - surgery</subject><subject>Lungs & airways</subject><subject>Male</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Muscle Strength</subject><subject>Muscle Strength - physiology</subject><subject>Non‐small cell</subject><subject>NSCLC</subject><subject>Oxygen Consumption</subject><subject>Postoperative Care</subject><subject>Postoperative Care - methods</subject><subject>Quadriceps Muscle</subject><subject>Quadriceps Muscle - physiology</subject><subject>Quality of Life</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Resistance Training</subject><subject>Time Factors</subject><subject>Treatment</subject><issn>1465-1858</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUhS0Eoj_wCpWXbGbwTxw7GySYthSpEhtYW45903FJ7MFOWmbHI_QZ-yR1mE5V2LCxLd3vnnOvD0InlCwpIew9rWpBlVDL1SkhTSPEcjO1_AU6nAuLufLy2fsAHeV8TQivGyZfowNOGakq3hyi67NfkKzPgMdkfPDhCk_BQRrNDwi43eINxE0P-NaPax8wZXiIYVxnHDvcT4VOkMGOPgbcxYRDDPe_7_Jg-h5bKMcfxppgIb1BrzrTZ3j7eB-j7-dn31YXi8uvn7-sPl4urOANXyjnnLGqVo6DpUTKxkrLeEVaCVXXuobx1qmWg6yIVKxtZcUN8IorUnPhFD9GH3a65UcGcBZCWa3Xm-QHk7Y6Gq__rgS_1lfxRtdCUkFZEXj3KJDizwnyqAef521MgDhlzZggNWGKioLWO9SmmHOC7smGEj0HpfdB6X1QszkvjSfPh3xq2ydTgE874Nb3sNU22nUq_v_R_cflAUmApo4</recordid><startdate>20190617</startdate><enddate>20190617</enddate><creator>Cavalheri, Vinicius</creator><creator>Burtin, Chris</creator><creator>Formico, Vittoria R</creator><creator>Nonoyama, Mika L</creator><creator>Jenkins, Sue</creator><creator>Spruit, Martijn A</creator><creator>Hill, Kylie</creator><creator>Cavalheri, Vinicius</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190617</creationdate><title>Exercise training undertaken by people within 12 months of lung resection for non‐small cell lung cancer</title><author>Cavalheri, Vinicius ; Burtin, Chris ; Formico, Vittoria R ; Nonoyama, Mika L ; Jenkins, Sue ; Spruit, Martijn A ; Hill, Kylie ; Cavalheri, Vinicius</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5393-8dddac868d3ec10779c7c2340b7e4fbd923bd8b3e740782bb743ae34380635d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Breathing Exercises</topic><topic>Cancer</topic><topic>Carcinoma, Non-Small-Cell Lung - rehabilitation</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Carcinoma, Non‐Small‐Cell Lung</topic><topic>Complementary & alternative medicine</topic><topic>Exercise Therapy</topic><topic>Exercise Tolerance</topic><topic>Exercise Tolerance - physiology</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Forced Expiratory Volume - physiology</topic><topic>Health Status</topic><topic>Holistic/complementary/non‐invasive therapies</topic><topic>Humans</topic><topic>Lung</topic><topic>Lung cancer</topic><topic>Lung Neoplasms</topic><topic>Lung Neoplasms - rehabilitation</topic><topic>Lung Neoplasms - surgery</topic><topic>Lungs & airways</topic><topic>Male</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Muscle Strength</topic><topic>Muscle Strength - physiology</topic><topic>Non‐small cell</topic><topic>NSCLC</topic><topic>Oxygen Consumption</topic><topic>Postoperative Care</topic><topic>Postoperative Care - methods</topic><topic>Quadriceps Muscle</topic><topic>Quadriceps Muscle - physiology</topic><topic>Quality of Life</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Resistance Training</topic><topic>Time Factors</topic><topic>Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cavalheri, Vinicius</creatorcontrib><creatorcontrib>Burtin, Chris</creatorcontrib><creatorcontrib>Formico, Vittoria R</creatorcontrib><creatorcontrib>Nonoyama, Mika L</creatorcontrib><creatorcontrib>Jenkins, Sue</creatorcontrib><creatorcontrib>Spruit, Martijn A</creatorcontrib><creatorcontrib>Hill, Kylie</creatorcontrib><creatorcontrib>Cavalheri, Vinicius</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cavalheri, Vinicius</au><au>Burtin, Chris</au><au>Formico, Vittoria R</au><au>Nonoyama, Mika L</au><au>Jenkins, Sue</au><au>Spruit, Martijn A</au><au>Hill, Kylie</au><au>Cavalheri, Vinicius</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Exercise training undertaken by people within 12 months of lung resection for non‐small cell lung cancer</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2019-06-17</date><risdate>2019</risdate><volume>2019</volume><issue>6</issue><spage>CD009955</spage><epage>CD009955</epage><pages>CD009955-CD009955</pages><issn>1465-1858</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
Decreased exercise capacity and health‐related quality of life (HRQoL) are common in people following lung resection for non‐small cell lung cancer (NSCLC). Exercise training has been demonstrated to confer gains in exercise capacity and HRQoL for people with a range of chronic conditions, including chronic obstructive pulmonary disease and heart failure, as well as in people with prostate and breast cancer. A programme of exercise training may also confer gains in these outcomes for people following lung resection for NSCLC. This systematic review updates our 2013 systematic review.
Objectives
The primary aim of this review was to determine the effects of exercise training on exercise capacity and adverse events in people following lung resection (with or without chemotherapy) for NSCLC. The secondary aims were to determine the effects of exercise training on other outcomes such as HRQoL, force‐generating capacity of peripheral muscles, pressure‐generating capacity of the respiratory muscles, dyspnoea and fatigue, feelings of anxiety and depression, lung function, and mortality.
Search methods
We searched for additional randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2019, Issue 2 of 12), MEDLINE (via PubMed) (2013 to February 2019), Embase (via Ovid) (2013 to February 2019), SciELO (The Scientific Electronic Library Online) (2013 to February 2019), and PEDro (Physiotherapy Evidence Database) (2013 to February 2019).
Selection criteria
We included RCTs in which participants with NSCLC who underwent lung resection were allocated to receive either exercise training, which included aerobic exercise, resistance exercise, or a combination of both, or no exercise training.
Data collection and analysis
Two review authors screened the studies and identified those eligible for inclusion. We used either postintervention values (with their respective standard deviation (SD)) or mean changes (with their respective SD) in the meta‐analyses that reported results as mean difference (MD). In meta‐analyses that reported results as standardised mean difference (SMD), we placed studies that reported postintervention values and those that reported mean changes in separate subgroups. We assessed the certainty of evidence for each outcome by downgrading or upgrading the evidence according to GRADE criteria.
Main results
Along with the three RCTs included in the original version of this review (2013), we identified an additional five RCTs in this update, resulting in a total of eight RCTs involving 450 participants (180 (40%) females). The risk of selection bias in the included studies was low and the risk of performance bias high. Six studies explored the effects of combined aerobic and resistance training; one explored the effects of combined aerobic and inspiratory muscle training; and one explored the effects of combined aerobic, resistance, inspiratory muscle training and balance training. On completion of the intervention period, compared to the control group, exercise capacity expressed as the peak rate of oxygen uptake (VO2peak) and six‐minute walk distance (6MWD) was greater in the intervention group (VO2peak: MD 2.97 mL/kg/min, 95% confidence interval (CI) 1.93 to 4.02 mL/kg/min, 4 studies, 135 participants, moderate‐certainty evidence; 6MWD: MD 57 m, 95% CI 34 to 80 m, 5 studies, 182 participants, high‐certainty evidence). One adverse event (hip fracture) related to the intervention was reported in one of the included studies. The intervention group also achieved greater improvements in the physical component of general HRQoL (MD 5.0 points, 95% CI 2.3 to 7.7 points, 4 studies, 208 participants, low‐certainty evidence); improved force‐generating capacity of the quadriceps muscle (SMD 0.75, 95% CI 0.4 to 1.1, 4 studies, 133 participants, moderate‐certainty evidence); and less dyspnoea (SMD −0.43, 95% CI −0.81 to −0.05, 3 studies, 110 participants, very low‐certainty evidence). We observed uncertain effects on the mental component of general HRQoL, disease‐specific HRQoL, handgrip force, fatigue, and lung function. There were insufficient data to comment on the effect of exercise training on maximal inspiratory and expiratory pressures and feelings of anxiety and depression. Mortality was not reported in the included studies.
Authors' conclusions
Exercise training increased exercise capacity and quadriceps muscle force of people following lung resection for NSCLC. Our findings also suggest improvements on the physical component score of general HRQoL and decreased dyspnoea. This systematic review emphasises the importance of exercise training as part of the postoperative management of people with NSCLC.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>31204439</pmid><doi>10.1002/14651858.CD009955.pub3</doi><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1465-1858 |
| ispartof | Cochrane database of systematic reviews, 2019-06, Vol.2019 (6), p.CD009955-CD009955 |
| issn | 1465-1858 1465-1858 1469-493X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6571512 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Cochrane Library; Alma/SFX Local Collection |
| subjects | Breathing Exercises Cancer Carcinoma, Non-Small-Cell Lung - rehabilitation Carcinoma, Non-Small-Cell Lung - surgery Carcinoma, Non‐Small‐Cell Lung Complementary & alternative medicine Exercise Therapy Exercise Tolerance Exercise Tolerance - physiology Female Forced Expiratory Volume Forced Expiratory Volume - physiology Health Status Holistic/complementary/non‐invasive therapies Humans Lung Lung cancer Lung Neoplasms Lung Neoplasms - rehabilitation Lung Neoplasms - surgery Lungs & airways Male Medicine General & Introductory Medical Sciences Muscle Strength Muscle Strength - physiology Non‐small cell NSCLC Oxygen Consumption Postoperative Care Postoperative Care - methods Quadriceps Muscle Quadriceps Muscle - physiology Quality of Life Randomized Controlled Trials as Topic Resistance Training Time Factors Treatment |
| title | Exercise training undertaken by people within 12 months of lung resection for non‐small cell lung cancer |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-25T16%3A49%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Exercise%20training%20undertaken%20by%20people%20within%2012%20months%20of%20lung%20resection%20for%20non%E2%80%90small%20cell%20lung%20cancer&rft.jtitle=Cochrane%20database%20of%20systematic%20reviews&rft.au=Cavalheri,%20Vinicius&rft.date=2019-06-17&rft.volume=2019&rft.issue=6&rft.spage=CD009955&rft.epage=CD009955&rft.pages=CD009955-CD009955&rft.issn=1465-1858&rft.eissn=1465-1858&rft_id=info:doi/10.1002/14651858.CD009955.pub3&rft_dat=%3Cproquest_pubme%3E2250602815%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2250602815&rft_id=info:pmid/31204439&rfr_iscdi=true |