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S34 AN EARLY EXERCISE INTERVENTION PREVENTS QUADRICEPS WEAKNESS AFTER THORACOTOMY FOR NON-SMALL CELL LUNG CANCER: RANDOMISED CONTROLLED TRIAL
1G. Arbane, 1D. Jackson, 2D. Tropman, 3R. Garrod. 1St George’s University of London, London, UK, 2St George’s Healthcare NHS Trust, London, UK, 3King’s College Hospital NHS Foundation Trust, London, UK
Deterioration in exercise tolerance and impairment in quality of life (QoL) are common consequences of lung resection. This study evaluates additional exercise and strength training after lung resection on QoL, exercise tolerance and muscle strength.
53 (28 male) patients attending thoracotomy for lung cancer, mean age 64 years (range 32–82); mean pack years (SD) 31.9 (26.8); body mass index 25.6 (4.2); forced expiratory volume in 1 s (FEV1) 2.0 (0.7) litres, were randomised to control (usual care) or intervention (twice daily training plus usual care). After discharge the intervention group received monthly home visits and weekly telephone calls; the control group received monthly telephone calls up to 12 weeks. Assessment preoperatively, 5 days and 12 weeks postoperatively consisted of quadriceps strength using magnetic stimulation, 6 minute walking distance (6MWD) and QoL-EORTC-QLC-C3.
QoL was unchanged over 12 weeks; 6MWD showed significant deterioration at 5 days postoperatively compared with preoperatively, mean difference (SD) −131.6 (101.8) m and −128.0 (90.7) m in active and control groups, respectively (p = 0.89 between groups), which returned to preoperative levels by 12 weeks in both groups. Quadriceps strength over the 5 day inpatient period showed a decrease of −8.3 (11.3) kg in the control group compared with an increase of 4.0 (21.2) kg in the intervention group (p = 0.04 between groups).
Strength and mobility training provided after thoracotomy successfully prevented the sarcopenia seen in a control group; however, there was no effect on 6MWD or QoL. 6MWD returned to preoperative levels by 12 weeks regardless of additional support offered.