“Rehabilitation is the practice of improving a patient’s ability to function before surgery, with the aim of improving postoperative outcomes,” explained co-study author Stephanie Wynne, BSc. “In lung cancer surgery, [prehabilitation] it is associated with improved functional capacity and quality of life and reduced hospital stays, postoperative complications and readmission. “
Wynne explained that lung resection is the most common radical treatment for lung cancer, with the exception of only 10-30% of individuals being identified as true candidates for the procedure, “due to the prevalence of the disease. and several surgical risk factors, including advanced age or performance status, high comorbidities, and decreased cardiopulmonary reserve. “Recovery may help.
Although relapse usually occurs in a face-to-face setting, home choice is particularly attractive among COVID-19 pandemics.
The study included 20 patients undergoing lung surgery at a National Health Service Trust unit in London. All were provided with a personalized home exercise program, and a compliance monitoring diary. Patients also had written counseling and counseling for symptom management and had significant follow-up on a weekly or weekly basis.
Participants were assessed before and after the intervention on the following outcomes:
- MRC Dyspnoea scale
- Physical activity levels (measured by the Godwin Leisure Time Exercise Questionnaire) [GLTEQ])
- Dietary requirements
- Mood (measured by the Hospital Anxiety and Depression Scale) [HADS])
- Fatigue (measured by FACIT-fat)
- Exercise ability (measured by the 1-minute sit-to-stand test (STS))
The majority (65%) of participants were female, with the mean age at 68. At baseline, the average MRC score was Dyspnoea 2; 45% of patients had 5 or more comorbidities; 70% had a smoking history and 15% were classified as “vulnerable-slightly weak” according to the Rockwood Clinical Burden Score.
Although there was no change in the mean MRC-Dysponea scale, HADs, or obesity levels after the intervention, the researchers saw an average improvement of 45.9 points in the GLTEQ scores, and 100% of patients met recommended levels of physical activity. In addition, the average STS score grew 5.1 points, which exceeded the lowest clinical difference of +3.
“To conclude, our findings show that it is possible to have remote accommodation at home, [and it] it may improve patients’ pre-surgery physical activity and exercise level, ”said Wynne. “This is relevant given the continuing uncertainty surrounding COVID-19 and its impact on the delivery of face-to-face healthcare.”
Although this study showed that rehabilitation at home may work in patients, the authors note that it should be further investigated, especially for elderly or older patients. -lephants with limited access to technology.
“We are now designing a triage device to best support patients based on their therapeutic needs and access to technology,” Wynne said.
Information
Wynne S, Dickinson F. Delivering thoracic rehabilitation during COVID-19: a review of a significant model. Presented at: 2020 World Conference on Lung Cancer. January 28-21, 2021.