Physiotherapy interventions and outcomes following lung cancer surgery

Sammanfattning: The aim of this thesis was to evaluate the effect of exercise training and inspiratory muscle training and to describe pulmonary function, respiratory muscle strength, physical performance and health-related quality of life (HRQoL) following lung cancer surgery.Study I was a randomised controlled trial including 78 patients radically operated for lung cancer. The intervention group received 10 sessions of supervised exercise training in addition to home-based exercise; the control group was instructed on home-exercise alone. Supervised compared to non-supervised exercise training did not result in differences between groups in HRQoL, except for the SF-36 bodily pain domain four months after the surgery. No effects of supervised training were found for any outcome after one year. Study II was descriptive and was based on the study I sample. We evaluated the course of recovery of HRQoL and physical performance up to one year following surgery. All patients improved HRQoL and physical performance one year after the surgery, reaching values comparable to a reference healthy population. The walked distance was positively associated with the SF-36 domain for physical functioning. Study III was descriptive, included 81 patients and evaluated the influence of surgery on respiratory muscle strength, lung function and physical performance two weeks and six months after surgery. We found that respiratory muscle strength was not affected after the second postoperative week and that muscle-sparring thoracotomy did not deteriorate respiratory muscle strength, compared to video-assisted thoracic surgery. Compared to preoperative values, physical performance was recovered, whereas lung function remained reduced six months postoperatively. Study IV was a randomised controlled trial including 68 patients at high risk of developing postoperative pulmonary complications (PPC). This study evaluated the effects of two weeks of postoperative inspiratory muscle training in addition to breathing exercises and early mobilisation on respiratory muscle strength and the incidence of PPC. Additional inspiratory muscle training did not increase respiratory muscle strength, but improved postoperative oxygenation. Respiratory muscle strength was recovered in both groups two weeks postoperatively.