Attila Vagvolgyi1, Zsolt Rozgonyi2, Maria Kerti3, Paul Vadasz1, Janos Varga2. 1. Department of Thoracic Surgery, National Koranyi Institute for Pulmonology and Semmelweis University, Budapest, Hungary. 2. Central Department of Anaesthesiology and Intensive Care, National Koranyi Institute for Pulmonology, Budapest, Hungary. 3. Department of Pulmonary Rehabilitation.
Abstract
BACKGROUND: Functional condition is crucial for operability of patients with lung cancer and/or chronic respiratory diseases. The aim of the study was to measure changes of functional and quality of life parameters in terms of the effectiveness of perioperative pulmonary rehabilitation (PR). METHODS: A total of 208 COPD patients (age: 63±9 years, man/woman: 114/94, FEV1: 62±14%pred) participated in a perioperative PR program. The indication was primary lung cancer in 72% of the patients. The 68 patients participated in preoperative (PRE) rehabilitation, 72 in a pre- and postoperative rehabilitation (PPO) and 68 patients only in postoperative rehabilitation (POS). PR program included respiratory training techniques, individualized training and smoking cessation. Lung function tests, 6 minutes walking distance (6MWD) were measured before and after the rehabilitation. Quality of life tests [COPD Assessment Test (CAT) and Modified Medical Research Council Dyspnoea Scale (mMRC)] were evaluated as well. RESULTS: There was a significant improvement in FEV1 (PRE: 64±16 vs. 67±16%pred; PPO: 60±13 vs. 66±13%pred before the operation, 48±13 vs. 52±13%pred after the operation; POS: 56±16 vs. 61±14%pred, P<0.05) and 6MWD (PRE: 403±87 vs. 452±86 m; PPO: 388±86 vs. 439±83 m before, 337±111 vs. 397±105 m after the operation; POS: 362±89 vs. 434±94 m, P<0 0001). Significant improvement was detected in FVC, grip strength, mMRC and CAT questionnaires as an effectiveness of PR, also. Average intensive care duration was 3.8±5.2 days with vs. 3.1±3.6 without preoperative PR. CONCLUSIONS: Improvements in exercise capacity and quality of life were seen following PR both before and after thoracic surgery.
BACKGROUND: Functional condition is crucial for operability of patients with lung cancer and/or chronic respiratory diseases. The aim of the study was to measure changes of functional and quality of life parameters in terms of the effectiveness of perioperative pulmonary rehabilitation (PR). METHODS: A total of 208 COPDpatients (age: 63±9 years, man/woman: 114/94, FEV1: 62±14%pred) participated in a perioperative PR program. The indication was primary lung cancer in 72% of the patients. The 68 patients participated in preoperative (PRE) rehabilitation, 72 in a pre- and postoperative rehabilitation (PPO) and 68 patients only in postoperative rehabilitation (POS). PR program included respiratory training techniques, individualized training and smoking cessation. Lung function tests, 6 minutes walking distance (6MWD) were measured before and after the rehabilitation. Quality of life tests [COPD Assessment Test (CAT) and Modified Medical Research Council Dyspnoea Scale (mMRC)] were evaluated as well. RESULTS: There was a significant improvement in FEV1 (PRE: 64±16 vs. 67±16%pred; PPO: 60±13 vs. 66±13%pred before the operation, 48±13 vs. 52±13%pred after the operation; POS: 56±16 vs. 61±14%pred, P<0.05) and 6MWD (PRE: 403±87 vs. 452±86 m; PPO: 388±86 vs. 439±83 m before, 337±111 vs. 397±105 m after the operation; POS: 362±89 vs. 434±94 m, P<0 0001). Significant improvement was detected in FVC, grip strength, mMRC and CAT questionnaires as an effectiveness of PR, also. Average intensive care duration was 3.8±5.2 days with vs. 3.1±3.6 without preoperative PR. CONCLUSIONS: Improvements in exercise capacity and quality of life were seen following PR both before and after thoracic surgery.
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