None listed
Conditions
Brief summary
This study is aiming to assess whether a 'prehabilitation' exercise program that is completed prior to any cancer treatments, is feasible and beneficial for patients with non-small cell lung cancer. Who is it for? You may be eligible for this study if you are aged 18-85, you have been diagnosed with inoperable (not eligible for surgical removal) non-small cell lung cancer, and you have not yet started any chemotherapy or radiotherapy to treat your cancer. Study details All participants who choose to enrol in this study will be given an individualised exercise program to complete 2-4 days per week, depending upon their health and ability to complete the exercises. At least two 60 minute sessions will be completed each week at the hospital rehabilitation centre under the supervision of a senior physiotherapist. An additional 1-2 sessions will be completed by participants at home. Each exercise session will include walking on a treadmill or outside, as well as some resistance exercises that target different muscle groups. The exercise sessions will run between 4-8 weeks prior to any cancer treatment that doctors have prescribed, this will vary for each participant. It is hoped this research may be used to improve health outcomes for people with inoperable lung cancer by determining whether a pre-treatment rehabilitation program is feasible and whether it has any impact on their overall health after starting medical treatment.
Interventions
The prehabilitation exercise program will be delivered during the weeks participants will be awaiting medical treatment commencement. It is anticipated that the duration of the program will be between 4 and 8 weeks based on current waiting time for treatment commencement (6 weeks on average). The supervised sessions will be delivered at Fiona Stanley Hospital (FSH) or at a Community Physiotherapy Service site (e.g. Melville and Rockingham), or at Rockingham General Hospital (RGH) at least twice
The prehabilitation exercise program will be delivered during the weeks participants will be awaiting medical treatment commencement. It is anticipated that the duration of the program will be between 4 and 8 weeks based on current waiting time for treatment commencement (6 weeks on average). The supervised sessions will be delivered at Fiona Stanley Hospital (FSH) or at a Community Physiotherapy Service site (e.g. Melville and Rockingham), or at Rockingham General Hospital (RGH) at least twice a week.The group size will be dependant on number of participants attending on that day. Each supervised prehabilitation exercise session will last 60 minutes and comprise walking training, and resistance exercises for the upper and lower limbs. Exercise intensity and progression will be undertaken in accordance with current international pulmonary rehabilitation guidelines (Spruit MA et al, 2013; DOI: 10.1164/rccm.201309-1634ST). The prehabilitation exercise program will be embedded in the pulmonary rehabilitation programs of the included sites. As per in pulmonary rehabilitation, participants will also be provided with an individualised home program that includes walking and resistance exercises to complete on an additional 1 to 2 days each week during the prehabilitation program. The number of prescribed home exercise days will be determined at baseline assessment. The participant will be given a log book to capture number of home exercise sessions. As some of the resistance exercises require a resistance exercise band (theraband), the band will be provided to participants without any extra cost to them. The home exercise program will consist of a number of resistance exercises including step ups, sit to stand and wall push-ups, as well as exercises using the theraband. The duration of the home program sessions will be 30 minutes. The initial speed for the walking training will be set at between 70% and 80% of the average speed achieved during the baseline 6-minute walk test. Resistance training for upper and lower limbs will be prescribed according to participants’ symptoms (between 4-6 on the BORG scale for dyspnoea or 12-16 on the rating of perceived exertion [RPE] scale). Progression of exercise training will also be based on participants’ symptoms. All assessments and exercise training will be conducted by a senior physiotherapist.
Sponsors
South Metropolitan Health Service
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria will comprise adults (i) with primary non-small cell lung cancer, (ii) Eastern Cooperative Organisation Group (ECOG) performance status between 0 and 2 (scales ranges between 0 and 4, with lower scores indicating better performance status); and (iii) referred to treatments other than lung resection at FSH.
Exclusion criteria
Exclusion criteria: Patients with brain metastasis, acute illness or any musculoskeletal, cardiovascular (symptomatic heart disease) or neurological disorder that could inhibit performing exercise will be excluded. For those patients willing to exercise at one of the Community Physiotherapy Service sites, an additional exclusion criterion is resting peripheral oxygen saturation (SpO2) less than or equal to 91%, and SpO2 less than or equal to 85% during the 6-minute walk test. Further, participants will be required to complete questionnaires and understand instructions, which require them to be able to read and understand English. Therefore, we are specifically excluding people who have an inability to read and understand English.
Outcome results
None listed