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Effect of postsurgical rehabilitation programmes in patients operated for lung cancer: a systematic review and meta-analysis
Sommer MS, Staerkind MEB, Christensen J, Vibe-Petersen J, Larsen KR, Pedersen JH, Langberg H
Journal of Rehabilitation Medicine 2018 Feb;50(3):236-245
systematic review

OBJECTIVE: To review the evidence concerning the effects of postoperative exercise interventions on exercise capacity and health-related quality of life following resection for non-small cell lung cancer, and to review whether different initiation times of exercise produce different effects on exercise capacity. DATA SOURCES: Comprehensive literature search of Medline, Embase, CENTRAL, CINAHL and PEDro. STUDY SELECTION: Randomized controlled trials examining the effects of exercise interventions were eligible for inclusion. DATA EXTRACTION: Postoperative outcome measurements were extracted and the quality of evidence was graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. DATA SYNTHESIS: Four randomized controlled trials were identified involving 262 participants. Short-term follow-up (12 to 20 weeks) showed significantly higher exercise capacity and physical component of health-related quality of life in the intervention group (standardized mean difference (SMD) 0.48; 95% confidence interval (CI) 0.04 to 0.93) compared with the control group (SMD 0.50; 95% CI 0.19 to 0.82). There was no difference between the effect of late- and early-initiated exercise intervention. CONCLUSION: Exercise has a small-to-moderate effect at short-term follow-up on exercise capacity and the physical component of health-related quality of life in patients operated for lung cancer. The long-term effects of exercise capacity are unknown. Early-initiated exercise programmes (2 weeks post-operation) did not show an effect on exercise capacity. These findings should be interpreted with caution.

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