David J Finley1, Courtney J Stevens2, Jennifer A Emond3, John A Batsis4, Kayla A Fay5, Christian Darabos6, Olivia A Sacks7, Summer B Cook8, Kathleen Doyle Lyons9. 1. Department of Surgery, Section Thoracic Surgery, Dartmouth-Hitchcock Health, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: David.J.Finley@hitchcock.org. 2. Department of Psychiatry, Dartmouth-Hitchcock Health, Dartmouth Centers for Health & Aging, 46 Centerra Parkway, Lebanon, NH, 03756, USA. Electronic address: Courtney.j.stevens@dartmouth.edu. 3. Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: Jennifer.A.Emond@dartmouth.edu. 4. Department of Medicine, Dartmouth-Hitchcock Health, The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: john.batsis@gmail.com. 5. Department of Surgery, Section of Thoracic Surgery, Dartmouth-Hitchcock Health, 1 Medical Center Dr., Lebanon, NH, 03756, USA. Electronic address: Kayla.A.Fay@hitchcock.org. 6. Information, Technology and Consulting, Dartmouth College, 4 Currier Place, Hanover, NH, 03748, USA; Department of Biomedical Data Sciences, Geisel School of Medicine, Dartmouth College, 1 Medical Center Drive, Lebanon, NH, 03756, USA. Electronic address: Christian.Darabos@dartmouth.edu. 7. Department of Surgery, Boston Medical Center, 1 Boston Medical Center Place, Boston, MA, 02118, USA. Electronic address: Olivia.Sacks@bmc.org. 8. Department of Kinesiology, University of New Hampshire, 124 Main Street, Durham, NH, 03824, USA. Electronic address: summer.cook@unh.edu. 9. Department of Psychiatry Research, Dartmouth-Hitchcock Health, 1 Medical Center Dr., Lebanon, NH, 03756, USA. Electronic address: Kathleen.D.Lyons@dartmouth.edu.
Abstract
OBJECTIVES: Pre-operative exercise may improve functional outcomes for lung cancer patients, but barriers associated with cost, resources, and burden make it challenging to deliver pre-operative exercise programs. The goal of this proof-of-concept study was to determine level of moderate-vigorous physical activity (MVPA) and change in aerobic capacity after participation in a home-based pre-operative exercise intervention. MATERIALS AND METHODS: Eighteen patients scheduled for surgery for suspected stage I-III lung cancer received an exercise prescription from their surgeon and wore a commercially-available device that tracked their daily MVPA throughout the pre-operative period. Descriptive statistics were used to calculate adherence to the exercise prescription. A one-sample t-test was used to explore change in aerobic capacity from baseline to the day of surgery. RESULTS: Participants exhibited a mean of 20.4 (sd = 46.2) minutes of MVPA per day during the pre-operative period. On average, the sample met the goal of 30 min of MVPA on 16.4% of the days during the pre-operative period. The mean distance achieved at baseline for the 6-min walk test was 456.7 m (sd = 72.9), which increased to 471.1 m (sd = 88.4) on the day of surgery. This equates to a mean improvement of 13.8 m (sd = 37.0), but this difference was not statistically different from zero (p = 0.14). Eight of the 17 participants (47%) demonstrated a clinically significant improvement of 14 m or more. CONCLUSION: A surgeon-delivered exercise prescription plus an activity tracker may promote clinically significant improvement in aerobic capacity and MVPA engagement among patients with lung cancer during the pre-operative period, but may need to be augmented with more contact with and support from practitioners over time to maximize benefits. TRIAL REGISTRATION: The study protocol was registered with ClinicalTrials.gov prior to initiating participant recruitment (NCT03162718).
OBJECTIVES: Pre-operative exercise may improve functional outcomes for lung cancer patients, but barriers associated with cost, resources, and burden make it challenging to deliver pre-operative exercise programs. The goal of this proof-of-concept study was to determine level of moderate-vigorous physical activity (MVPA) and change in aerobic capacity after participation in a home-based pre-operative exercise intervention. MATERIALS AND METHODS: Eighteen patients scheduled for surgery for suspected stage I-III lung cancer received an exercise prescription from their surgeon and wore a commercially-available device that tracked their daily MVPA throughout the pre-operative period. Descriptive statistics were used to calculate adherence to the exercise prescription. A one-sample t-test was used to explore change in aerobic capacity from baseline to the day of surgery. RESULTS: Participants exhibited a mean of 20.4 (sd = 46.2) minutes of MVPA per day during the pre-operative period. On average, the sample met the goal of 30 min of MVPA on 16.4% of the days during the pre-operative period. The mean distance achieved at baseline for the 6-min walk test was 456.7 m (sd = 72.9), which increased to 471.1 m (sd = 88.4) on the day of surgery. This equates to a mean improvement of 13.8 m (sd = 37.0), but this difference was not statistically different from zero (p = 0.14). Eight of the 17 participants (47%) demonstrated a clinically significant improvement of 14 m or more. CONCLUSION: A surgeon-delivered exercise prescription plus an activity tracker may promote clinically significant improvement in aerobic capacity and MVPA engagement among patients with lung cancer during the pre-operative period, but may need to be augmented with more contact with and support from practitioners over time to maximize benefits. TRIAL REGISTRATION: The study protocol was registered with ClinicalTrials.gov prior to initiating participant recruitment (NCT03162718).
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