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Exercise training in patients with non-small cell lung cancer during in-hospital chemotherapy treatment: a randomized controlled trial
Rutkowska A, Jastrzebski D, Rutkowski S, Zebrowska A, Stanula A, Szczegielniak J, Ziora D, Casaburi R
Journal of Cardiopulmonary Rehabilitation and Prevention 2019 Mar;39(2):127-133
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 versus 531 +/- 103 m, p = 0.01). In a battery of physical performance tests: Up and Go Test (6.3 +/- 1.0 versus 6.0 +/- 1.1 sec, p = 0.01); chair stand (13.3 +/- 2.8 versus 14.3 +/- 3.4 repetitions, p = 0.001); and arm curl (18.4 +/- 3.1 versus 20.4 +/- 3.5 repetitions, p = 0.001) all improved significantly. Spirometry values also improved: FEV1 % predicted (76 +/- 16 versus 84 +/- 15, p = 0.01), FVC % predicted (87 +/- 14 versus 95 +/- 13, p = 0.01), and FEV1/FVC (73 +/- 13% versus 76 +/- 12%, p = 0.04). 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.
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