Preliminary efficacy of preoperative exercise training in patients with lung malignancies undergoing VATS

Introduction: Preoperative exercise training can improve the baseline status of patients undergoing open thoracic surgery and therefore improve surgical tolerability and enhance postoperative recovery. The aim of this study was to assess the feasibility and preliminary efficacy of a preoperative exercise-based programme (PEP) in patients undergoing Video-assisted thoracic surgery (VATS) for lung cancer. Materials and Methods: In a randomized, single blinded controlled trial, 20 patients were allocated to receive a PEP consisted of 3 - 5 sessions per week of interval endurance training, strength training with elastic bands and breathing exercises. Exercise capacity (endurance time), muscle strength (Senior Fitness Test) and health-related quality of life (SF-36) were assessed at the beginning and at the end of the training. Results: 10 patients completed the intervention attending a median of 16 sessions. Mean therapeutic delay was 54 days and no adverse events were recorded. There were statistically significant improvements in endurance time measured at 80% of the maximal workload (mean difference +396.6±197.9 seconds, p<.001), upper and lower body strength (mean difference +2.9±2.1 repetitions, p=.002 and +0.9±1.2 repetitions, p=.041) and in the role physical and physical summary component of the SF-36 (p=.038 and .008 respectively). Conclusions: preoperative exercise training in patients with lung malignancies awaiting VATS is safe and can be achieved without any delay in the surgical management and results effective to improve exercise capacity, muscle strength and physical functioning, which could potentially enhance postoperative recovery.