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

Official title

The Effect of Preoperative Structured Exercise Programme on Postoperative Pain Severity, Recovery Level, Discharge Time and Quality of Life in Patients With Non-Small Cell Lung Cancer: Randomised Controlled Study

Overview

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.

Interventions

• Other 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

Primary outcome measures

• Health-Related Quality of Life (EQ-5D-5L) [Time frame: Change from baseline scores on the 7th postoperative day.]
• Postoperative Pain Intensity (Numeric Rating Scale, NRS) [Time frame: Change from baseline scores on the 48 hours postoperatively.]
• Postoperative Surgical Recovery (Surgical Recovery Scale) [Time frame: Change from baseline scores on the 7th postoperative day.]

Secondary outcome measures (1)

• Length of Hospital Stay [Time frame: Approximately the seventh day.]

Eligibility criteria

Inclusion criteria

• Age ≥ 18 years.
• Ownership of a smartphone capable of tracking daily walking time.
• Diagnosis of primary non-small cell lung cancer.
• ASA (American Society of Anesthesiologists) classification I, II, or III.
• Follow-up and treatment provided by the same surgical team.
• No physical or cognitive impairment that would hinder participation in the study.

Exclusion criteria

• Diagnosis of recurrent lung cancer.
• Previous radiotherapy treatment prior to surgery.
• Any condition preventing walking or exercise (orthopedic, neurological, cardiovascular, metastatic, etc.).
• Diagnosis of additional respiratory system disease such as COPD, asthma, or emphysema preventing breathing exercises.
• Inability to complete the two-week structured exercise programme due to surgery being scheduled earlier or later than planned.
• Complications resulting in prolonged (>24 hours) intensive care unit stay after surgery.
• Inability to discontinue or continue the structured exercise programme at any stage.
• Refusal to participate in the study.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Other

Study locations

Turkey (Türkiye) · 1 center

• Hacettepe University, Ankara, Altındağ 06230 — Ankara

Publications

• Yilmaz B, Yayla A. Validity and Reliability Study of the Turkish Version of the Surgical Recovery Scale. J Perianesth Nurs. 2025 Oct;40(5):1281-1289. doi: 10.1016/j.jopan.2025.01.023. Epub 2025 Jun 20. PMID 40542811
• Machado P, Pimenta S, Garcia AL, Nogueira T, Silva S, Dos Santos CL, Martins MV, Canha A, Oliveiros B, Martins RA, Cruz J. Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial. Ann Surg Oncol. 2024 Feb;31(2):847-859. doi: 10.1245/s10434-023-14503-2. Epub 2023 Nov 7. PMID 37934383
• Jiao M, Liang H, Zhang M. Effect of exercise on postoperative recovery of patients with non-small cell lung cancer: a systematic review and meta-analysis. Discov Oncol. 2024 Jun 17;15(1):230. doi: 10.1007/s12672-024-01079-w. PMID 38884823

Identifiers

NCT: NCT07401056 · HAE24/90

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗