Wearable device-based exercise intervention improves activity levels after lung cancer surgery

In patients who are undergoing a surgical procedure for lung cancer, perioperative exercise interventions using wearable devices may help increase physical activity and improve dyspnoea after the procedure when compared with usual care, according to a study.

The study included 74 patients (mean age 60.4 years, 41.9 percent male) with suspected or confirmed nonsmall cell lung cancer who were scheduled for curative surgery more extensive than lobectomy and had an Eastern Cooperative Oncology Group status of 0 or 1. These patients were assigned to undergo a personalized exercise regimen, which was tracked using a wearable device, at home in 3 stages: preoperative (from diagnosis to surgery), immediate (from discharge to 2 months after surgery), and later postoperative (from 2 to 6 months after surgery).

The co-primary outcomes were cardiopulmonary function (6-minute walking distance [6MWD]) and physical activity levels (number of daily steps) at 6 months after the surgical procedure. Secondary outcomes included changes in cardiopulmonary function, physical activity, and health-related quality of life (HRQOL), including function and symptoms from baseline to 2 weeks and 6 months after surgery. Number of daily steps at 2 weeks postoperatively and time spent on moderate-to-vigorous physical activity (MVPA) at 2 weeks and 6 months postoperatively were also evaluated. These outcomes were compared between the intervention cohort and a historical cohort of 120 patients (mean age 60.2 years, 54.2 percent male) who received usual care.

An initial decrease in daily steps, MVPA, and 6MWD was documented at 2 weeks, followed by a subsequent increase. The number of daily steps at 2 weeks declined with a greater magnitude in the control group than in the intervention group (−4,877 vs −1,753 steps). By 6 months, the intervention group had significantly more daily steps (12,321 vs 10,118; p=0.007) and had greater time spent on MVPA (33.6 vs 18.5 min; p=0.003) compared with the control group.

No difference in 6MWD was found. However, relative to the control group, the intervention group had significantly better patient-reported physical function (mean score, 82.2 vs 76.9; p=0.04), less dyspnoea (mean score, 24.8 vs 34.5; p=0.03), and less pain (mean score, 21.4 vs 30.1; p=0.01) at 2 weeks, as well as less dyspnoea at 6 months (mean score, 5.4 vs 12; p=0.01).