Article

OBJECTIVE: To evaluate the effect of 4 weeks of pulmonary rehabilitation (PR)
versus chest physical therapy (CPT) on the preoperative functional capacity and
postoperative respiratory morbidity of patients undergoing lung cancer resection.
DESIGN: Randomized single-blinded study. SETTING:
A teaching hospital.
PARTICIPANTS: Patients undergoing lung cancer resection (N=24). INTERVENTIONS:
Patients were randomly assigned to receive PR (strength and endurance training)
versus CPT (breathing exercises for lung expansion). Both groups received
educational classes. MAIN OUTCOME MEASURES: Functional parameters assessed before
and after 4 weeks of PR or CPT (phase 1), and pulmonary complications assessed
after lung cancer resection (phase 2). RESULTS: Twelve patients were randomly
assigned to the PR arm and 12 to the CPT arm. Three patients in the CPT arm were
not submitted to lung resection because of inoperable cancer. During phase 1
evaluation, most functional parameters in the PR group improved from baseline to
1 month: forced vital capacity (FVC) (1.47L [1.27-2.33L] vs 1.71L [1.65-2.80L],
respectively; P=.02); percentage of predicted FVC (FVC%; 62.5% [49%-71%] vs 76%
[65%-79.7%], respectively; P<.05); 6-minute walk test (425.5+/-85.3m vs
475+/-86.5m, respectively; P<.05); maximal inspiratory pressure (90+/-45.9cmH(2)O
vs 117.5+/-36.5cmH(2)O, respectively; P<.05); and maximal expiratory pressure
(79.7+/-17.1cmH(2)O vs 92.9+/-21.4cmH(2)O, respectively; P<.05). During phase 2
evaluation, the PR group had a lower incidence of postoperative respiratory
morbidity (P=.01), a shorter length of postoperative stay
(12.2+/-3.6d vs
7.8+/-4.8d, respectively; P=.04), and required a chest tube for fewer days
(7.4+/-2.6d vs 4.5+/-2.9d, respectively; P=.03) compared with the CPT arm.
CONCLUSIONS: These findings suggest that 4 weeks of PR before lung cancer
resection improves preoperative functional capacity and decreases the
postoperative respiratory morbidity.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS