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Improvements in physical performance and health-related quality of life one year after radical operation for lung cancer
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Aalborg, Denmark.ORCID iD: 0000-0001-7085-6507
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Department of Cardiothoracic surgery and Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark.
Faculty of Medicine and Health, Surgery, Örebro University, Örebro, Sweden .
2015 (English)In: Cancer Treatment Communications, ISSN 2213-0896, Vol. 4, p. 65-74Article in journal (Refereed) Published
Abstract [en]

Micro abstract: This study assessed physical performance and health-related quality of life one year after lung cancer surgery and investigated the potential association between both outcomes. We found that the walked distance was associated with the subjective perception of the physical functioning. Patients improved health-related quality of life, reaching values similar to a healthy reference population.

Background: Resuming an acceptable level of lifestyle and health-related quality of life after lung cancer surgery has become an important issue. We aimed to evaluate the course of recovery of physical performance and health-related quality of life following pulmonary resection for lung cancer, as well as examine the potential association between these outcomes.

Methods: In an observational design, we assessed 78 individuals radically operated for lungcancer. We measured health-related quality of life (SF-36), six-minute walk test (6MWT) and lung function (spirometry)three weeks (baseline), four and twelve months after surgery. SF-36 values were compared to an age-and gender-matched reference population.

Results: The mean age was 65 years (SD9), 59% were males. Thoracotomy was performed in 77% of the cases. Compared to baseline values, we found significant improvements after one year in SF-36 physical and mental component summary components of large effect size (0.8 and 0.9 respectively). Values for both SF-36 summary components were comparable to those of the reference population. The improvement in 6MWT was of moderate effect size (0.6). We found a positive association between 6MWT and the SF-36 domain for physical functioning (β=0.05, 95% CI [0.00;0.09], p=0.03) one year after surgery.

Conclusion: Individuals who were radically operated for lung cancer improved health-related quality of life one year after surgery, reaching values similar to a healthy reference population. The walked distance was positively associated with the subjective perception of physical functioning. The clinical significance of these findings deserves further investigation.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 4, p. 65-74
Keywords [en]
Lung cancer; Surgery; Quality of life; SF-36; Six-minute walk test; Long-term
National Category
Surgery Physiotherapy
Identifiers
URN: urn:nbn:se:oru:diva-46376DOI: 10.1016/j.ctrc.2015.05.004OAI: oai:DiVA.org:oru-46376DiVA, id: diva2:866324
Available from: 2015-11-02 Created: 2015-11-02 Last updated: 2018-07-02Bibliographically approved
In thesis
1. Physiotherapy interventions and outcomes following lung cancer surgery
Open this publication in new window or tab >>Physiotherapy interventions and outcomes following lung cancer surgery
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to evaluate the effect of exercise training and inspiratory muscle training and to describe pulmonary function, respiratory muscle strength, physical performance and health-related quality of life (HRQoL) following lung cancer surgery.

Study I was a randomised controlled trial including 78 patients radically operated for lung cancer. The intervention group received 10 sessions of supervised exercise training in addition to home-based exercise; the control group was instructed on home-exercise alone. Supervised compared to non-supervised exercise training did not result in differences between groups in HRQoL, except for the SF-36 bodily pain domain four months after the surgery. No effects of supervised training were found for any outcome after one year.

Study II was descriptive and was based on the study I sample. We evaluated the course of recovery of HRQoL and physical performance up to one year following surgery. All patients improved HRQoL and physical performance one year after the surgery, reaching values comparable to a reference healthy population. The walked distance was positively associated with the SF-36 domain for physical functioning.

Study III was descriptive, included 81 patients and evaluated the influence of surgery on respiratory muscle strength, lung function and physical performance two weeks and six months after surgery. We found that respiratory muscle strength was not affected after the second postoperative week and that muscle-sparring thoracotomy did not deteriorate respiratory muscle strength, compared to video-assisted thoracic surgery. Compared to preoperative values, physical performance was recovered, whereas lung function remained reduced six months postoperatively.

Study IV was a randomised controlled trial including 68 patients at high risk of developing postoperative pulmonary complications (PPC). This study evaluated the effects of two weeks of postoperative inspiratory muscle training in addition to breathing exercises and early mobilisation on respiratory muscle strength and the incidence of PPC. Additional inspiratory muscle training did not increase respiratory muscle strength, but improved postoperative oxygenation. Respiratory muscle strength was recovered in both groups two weeks postoperatively.

Place, publisher, year, edition, pages
Örebro: Örebro university, 2015. p. 66
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 129
Keywords
lung cancer, surgery, quality of life, exercise, inspiratory muscle training, physical performance, pulmonary complications
National Category
Surgery Medical and Health Sciences
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-45728 (URN)978-91-7529-097-3 (ISBN)
Public defence
2015-11-23, Universitetssjukhuset, hörsal C1, Södra Grev Rosengatan, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2015-09-07 Created: 2015-09-07 Last updated: 2017-10-17Bibliographically approved

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Brocki, Barbara CristinaWesterdahl, Elisabeth

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