Preoperative Structured Exercise Programme on Patients With Non-Small Cell Lung Cancer

Condition(s) studied

Investigational drug(s) / intervention(s)

Prehabilitation (Structured Preoperative Exercise Programme): Participants in this arm will receive a structured preoperative exercise programme starting two weeks before surgery. The programme includes moderate-intensity walking for at least 30 minutes 5 days per week, deep breathing and coughing exercises four times daily, and hourly incentive spirometry exercises while awake. Participants will record daily adherence to the exercise programme, and compliance will be monitored through daily telephone follow-up by the researcher. Study-related data will be collected from patients admitted to the hospital at the end of the two-week preoperative period in accordance with the study protocol. In this regard, the measurements to be taken in the study will include: (1) Pain severity: At 6, 12, 24 and 48 hours after surgery; (2) Surgical recovery level: On the third and seventh days after surgery; (3) Quality of life: On the first day before surgery and on the seventh day after surgery. (4) In addition, patients' LOSs will be recorded.

Study summary

INTRODUCTION: Lung cancer is among the leading cancers, and surgery has a major role in treatment. Patients diagnosed with Non-Small Cell Lung Cancer (NSCLC) who are eligible for surgical treatment have a high risk of experiencing postoperative complications. Therefore, in recent years, the concept of prehabilitation has begun to gain importance. Within the scope of prehabilitation practices, patients are provided with programmes that include aerobic exercises and breathing exercises in the preoperative period.

AIM: This study aims to evaluate the effects of a structured exercise programme, including aerobic exercises and breathing exercises in the preoperative period, on postoperative pain severity, surgical recovery level, length of hospital stays (LOS), and quality of life (QoL) in patients diagnosed with NSCLC and planned for surgical treatment.

METHODS: The research is an experimental, parallel group-randomised controlled trial to be conducted with 62 participants followed in the Thoracic Surgery Outpatient Clinic of Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital and scheduled for surgery due to NSCLC. Patients will be equally assigned to the intervention and control groups using the block randomization method. In the intervention group, in the preoperative period, for two weeks and five days per week, at least 30 minutes of walking per day will be performed; in addition, for two weeks before surgery, throughout the entire week, during waking hours, 10 repetitions with incentive spirometer every hour, and daily four sessions of deep breathing \& coughing exercises will be performed as breathing exercises. In the control group, routine preoperative clinical procedures will be applied. In the postoperative period, pain severity, surgical recovery level, LOS, and QoL will be compared between the two groups. Data will be collected face-to-face by the researcher using the "Descriptive Characteristics Form", "EQ-5D-5L Quality of Life Scale", "Numeric Rating Scale (NRS)", and "Surgical Recovery Scale". Data on the length of hospital stay will be obtained from patient files. The data will be analysed using parametric and/or nonparametric tests through the SPSS.

CONCLUSION: The findings of the study are expected to contribute to strengthening holistic care approaches for the preoperative period in surgical nursing practices and to improving patient outcomes.

Eligibility

Primary outcome measure(s)

• Health-Related Quality of Life (EQ-5D-5L) — Change from baseline scores on the 7th postoperative day.
  The EQ-5D-5L is a self-reported questionnaire assessing five dimensions of health: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has five levels: no problems, mild problems, moderate problems, severe problems, and extreme problems. The questionnaire also includes a Visual Analog Scale (VAS) ranging from 0 (worst health) to 100 (best health) for participants to rate their current health status. Higher scores indicate better health.
• Postoperative Pain Intensity (Numeric Rating Scale, NRS) — Change from baseline scores on the 48 hours postoperatively.
  The NRS is an 11-point scale (0-10) used to assess pain intensity, where 0 indicates no pain and 10 indicates the worst possible pain. Patients rate their pain at each time point, and the average of the measurements will be used to assess postoperative pain. The NRS is validated for adults, including elderly patients and those with mild-to-moderate cognitive impairment.
• Postoperative Surgical Recovery (Surgical Recovery Scale) — Change from baseline scores on the 7th postoperative day.
  The Surgical Recovery Scale is a 13-item questionnaire assessing two sub-dimensions: "Impact on energy" and "Impact on daily activities." Items are scored using 6-point Likert scales, with higher scores indicating better recovery. The total score ranges from 8 to 73. This scale is validated with a Cronbach's α of 0.93.

Trial sites (1)

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