Authors (including presenting author) :
LEE KWS(1), YU TWD(1), CHAN CMA(1), CHEUNG HL(2)
Affiliation :
(1)Physiotherapy Department, Queen Elizabeth Hospital, (2)Department of Cardiothoracic Surgery, Queen Elizabeth Hospital
Introduction :
Lung cancer is the leading cause of cancer death in Hong Kong. Surgical resection remains the best curative form of treatment for early stage patients. Resection of lung parenchyma after lung surgery would lead to pulmonary function and exercise capacity loss and hence affect patient’s quality of life (QoL). Patients with lung resection surgery are encouraged to participate in an 8-week, 16 sessions Pulmonary Rehabilitation Program (PRP) to maximize their functional capacity through physical training.
Objectives :
To evaluate the pulmonary function, exercise capacity and QoL for patients with pulmonary lobectomy after participating PRP
Methodology :
It was a retrospective, longitudinal study design. Records of patients received PRP from January 2016 to September 2020 were retrieved via Clinical Management System and Physiotherapy records. Outcome measures included: pulmonary function evaluations by forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1); exercise tolerance measures by 6-minute walk test (6MWT) and stair-climbing test (SCT); health-related quality of life (HRQoL) measures by MOS SF-12. Analysis were conducted before surgery (pre-op), before participation of PRP (pre-test), after completion of 16-session PRP (post-test) and 6-month after the surgery (post-op follow-up). Repeated measure ANOVA was used for statistical analysis.
Result & Outcome :
Sixty-nine patients with lung lobectomy completed 16-session PRP training program in the studying period and their records were retrieved and analysed. Mean age was 64.0±10.0 years old. Seventy-four percent were female patients. There were significant reductions in pulmonary function and exercise capacity after the surgery (FVC reduced by 14.7%, FEV1 reduced by 20%; 6MWT reduced by 13.8%, SCT reduced by 19.7%). For HRQoL, the physical and mental components of the MOS SF-12 were reduced by 8.2% and 7.5% respectively. After 16-session PRP, all patients showed significant improvement in pulmonary function test (improved 23.7% in FVC (p< 0.001) and 17.3% in FEV1 (p< 0.001)), exercise capacity (improved 18.7% in 6MWT (p=0.011) and 29.2% in SCT (p< 0.001)). For HRQoL, the physical component and mental component of the MOS SF-12 was improved by 21.3% and 20% respectively (p< 0.001). These improvements were maintained at 6-month after the surgery. The FVC could return to pre-operative level while the 6MWT, SCT performance and HRQoL were even better than pre-operative state. However, the FEV1 could only return to 94% of pre-operative level. Pulmonary resection caused reduction in pulmonary function and exercise tolerance in patients with lung tumour. Patient’s QoL was also greatly affected. Our results showed that PRP was effective in maximizing patients’ pulmonary function, exercise capacity and improve their QoL after lung resection surgery.
