Abstract
Purpose: The aim of this study was to perform a randomized trial to assess the impact of exercise training in patients with non-small cell lung cancer during chemotherapy on several outcomes in comparison to a control group (CG).
Methods: The exercise training group (ETG) consisted of 20 patients and the CG consisted of 10 patients. In the ETG, a 4-wk in-hospital exercise training program was performed in 2-wk cycles interspersed with consecutive rounds of chemotherapy with cytostatic drugs. The exercise training program was individualized and included warm-up, respiratory muscle exercise, training on a cycle ergometer or treadmill, and Nordic walking. CG participants were assessed before and after 6 wk of chemotherapy alone.
Results: Comparing pre- and post-intervention values, the ETG demonstrated an increase in 6-min walk distance (486 +/- 92 vs 531 +/- 103 m, P = .01). In a battery of physical performance tests: Up and Go Test (6.3 +/- 1.0 vs 6.0 +/- 1.1 sec, P = .01); chair stand (13.3 +/- 2.8 vs 14.3 +/- 3.4 repetitions, P = .001); and arm curl (18.4 +/- 3.1 vs 20.4 +/- 3.5 repetitions, P = .001) all improved significantly. Spirometry values also improved: FEV1 % predicted (76 +/- 16 vs 84 +/- 15, P = .01), FVC % predicted (87 +/- 14 vs 95 +/- 13, P = .01), and FEV1/FVC (73 +/- 13% vs 76 +/- 12%, P = .04). The exercise training was well tolerated, without any adverse events due to exercise. There were no significant improvements in the CG.
Conclusions: This study suggests that planned, individualized, and supervised exercise programs in patients with advanced lung cancer during chemotherapy are a practical and beneficial intervention for enhancing mobility and physical fitness.