Implementation of the physical activity guidelines in lung cancer: The CAPACITY study

Introduction: Physical activity (PA) is important in lung cancer yet the majority of patients do not meet minimum recommended levels. Aims: To determine if a PA self-management program is feasible and effective at preventing decline in PA, which commonly occurs after surgery. Method: Prospective case series. 40 patients (55% male, mean age 66±10years) with newly diagnosed operable lung cancer. The intervention was a PA program based on the cancer PA guidelines, commenced pre-surgery (if recruitment occurred >7days prior to surgery) or post-surgery if not and continued to 8weeks post-surgery. It included prescription of an unsupervised home exercise program, provision of a Fitbit (activity monitor), education and weekly telephone support. Outcomes: feasibility, self-reported PA, function, symptoms, self-efficacy and health-related quality of life (HRQoL) assessed pre-surgery and 2weeks, 8weeks and 6months post-surgery. Results: 16% of patients commenced the intervention pre-surgery and 84% commenced post-surgery. Median[IQR] number of intervention sessions (face-to-face or telephone) delivered was 4[3-6] per patient. There was no change in PA levels (total estimated mets/week pre-op=1543±1501, 8weeks=1748±2581, p=0.72), sedentary time (sitting hours/day pre-op= 6.1±3.6, 8-weeks=5.6±2.7, p=0.59), function (p=0.39) or dyspnoea (p=0.51) from pre to 8weeks post-surgery and global HRQoL improved (p=0.005) over this time. 63% and 67% met PA guidelines pre-op and 8weeks respectively. Conclusion: The PA program was feasible when implemented in the post-surgical setting. Compared with published literature that shows decline, patients maintained their PA levels after surgery.