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A six-week inspiratory muscle training and aerobic exercise improves respiratory muscle strength and exercise capacity in lung cancer patients after video-assisted thoracoscopic surgery: a randomized controlled trial [with consumer summary]
Liu J-F, Kuo N-Y, Fang T-P, Chen J-O, Lu H-I, Lin H-L
Clinical Rehabilitation 2021 Jun;35(6):840-850
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; 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*

OBJECTIVE: To compare the postoperative outcomes of inspiratory muscle training and aerobic exercise, along with standard care, on lung cancer patients undergoing video-assisted thoracoscopic surgery (VATS). DESIGN: A parallel-group, single-blind randomized clinical trial. SETTING: Thoracic surgery ward and outpatient clinic in a teaching hospital. SUBJECTS: Overall 63 patients underwent VATS were randomly assigned to a triaging (TG, n = 32) or control group (CG, n = 31). A total of 54 patients (TG, n = 26; CG, n = 28) completed the study. INTERVENTION: TG: six-week threshold inspiratory muscle training and aerobic exercise. CG: standard care. MAIN MEASURES: Maximum inspiratory pressure (PImax), maximum expiratory pressure (PEmax) lung expansion volume, and 6-min walking test (6MWT) were performed on the day of chest tube removal (baseline), and 2, 6, and 12 weeks postoperatively. RESULTS: The TG showed significant improvement in PImax at week 6 (71.6 +/- 34.9 versus 94.3 +/- 32.8 cmH2O, p = 0.018), PEmax at week 2 (70.9 +/- 24.3 versus 90.9 +/- 28.2 cmH2O, p = 0.015) and week 12 (76.1 +/- 20.2 versus 98.6 +/- 35.3 cmH2O, p = 0.012), the lung expansion volume at week 2 (1,080 +/- 433 versus 1,457 +/- 624 mL, p = 0.02) and week 12 (1,200 +/- 387 versus 1,885 +/- 678 mL, p < 0.001), in addition to the 6MWT at week 2 (332 +/- 78 versus 412 +/- 74 m, p = 0.002), week 6 (360 +/- 70 versus 419 +/- 60 m, p = 0.007) and week 12 (360 +/- 58 versus 402 +/- 65 m, p = 0.036). CONCLUSION: A six weeks of inspiratory muscle training and aerobic exercise had improved respiratory muscle strength and aerobic exercise postoperatively in lung cancer patients after VATS as early as 2 weeks.

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