Cancer And Physical ACtivITY (CAPACITY) trial: A randomised control trial of exercise and self-management for people with lung cancer

Intervention arm: In addition to usual care, participants randomised to the intervention arm will also receive an exercise and education self-management program after surgery. The intervention implements the American College of Sports Medicine Physical Activity Guidelines for people with cancer (Schmitz et al Med Sci Sports Exer 2005;14). The program consists of a face to face appointment with a physiotherapist occur post-operatively on the hospital ward before discharge. The session can be split over two times/days if needed, with a total duration of 15 to 45 minutes (depending on the needs of the participant). The session(s) include 1) assessing the patient’s readiness for physical activity behavioural change, goals and confidence; 2) verbal education with the patient +/- carers and family about physical activity; 3) provision of resources to support physical activity (including an activity monitor, exercise diary and booklet); 4) setting personalized physical activity goals with the patient and a home program; and 5) identifying barriers and enablers for the patient to achieve the physical activity goals. All participants will be prescribed a home walking program and this will be progressed towards performing 150 minutes per week at a moderate intensity based on the American College of Sports Medicine Physical Activity Guidelines for people with cancer (Schmitz et al Med Sci Sports Exer 2005;14). In addition participants will be prescribed a home resistance training program, using body weight, that are targeting major muscle groups and progressed towards performing this two to three times per week. The exercises including type of exercise, repetition number, frequency and duration are tailored to the individual patient's ability. The intervention is personalised to the individual participant’s needs because patients with lung cancer present with other comorbid disease, including depression and COPD, and therefore to improve efficacy a targeted approach to physical activity is required that addresses the participants individual goals and that can be prescribed from their current physical activity levels. The patient will receive weekly phone calls to promote adherence to the set physical activity goals, discuss barriers/issues and progress exercise. The phone calls occur weekly after hospital discharge for 3 months. The duration of the phone calls will be 5 to 20 minutes each depending on the needs of the participant. Participants will be asked to keep an exercise diary during the intervention period to record their daily exercises and physical activity levels.