Lung Neoplasms
Conditions
Keywords
Pulmonary rehabilitation, surgery, exercise
Brief summary
The advantages of thoracoscopic surgery include smaller wounds, fewer postoperative complications, and shortened hospital stay. However,complications such as pain, pulmonary function insufficiency, pneumonia,postoperative pneumothorax, persistent air leakage, subcutaneous emphysema, cough, and hemoptysis may occur in older patients after thoracoscopic surgery. Pulmonary rehabilitation has been demonstrated by evidence-base medicine could effectively reduce pulmonary complications and dyspnea as well as improve lung function, quality of life, exercise ability, and functional status of patients after traditional heart and thoracic surgery. Studies have suggested that pulmonary rehabilitation should be performed for at least 4 weeks to optimize the training effect .However, most patients who undergo thoracoscopic surgery were discharged within 3-5 days. Such a short hospital stay impeded the delivery of pulmonary rehabilitation. Home-based pulmonary rehabilitation appeared to be an option for these patients The purpose of this study is to determine whether Pulmonary rehabilitation are effective on patients who had thoracic surgeries.
Detailed description
Pulmonary-related surgeries remain some potential risks according to the previous evidence-based studies. Particularly, individuals who were over 65 years of age with smoking, chronic pulmonary disease, wheezy, cardiovascular comorbidities, upper respiratory infection were at the high risk of pulmonary complications after surgery,which accounted for approximately 2% to 40% of occurrence rate. The average mortality rate due to surgery was approximately 2%-8% in patients aged more than 65 years.Pulmonary rehabilitation could effectively reduce pulmonary complications and dyspnea as well as improve lung function, quality of life, exercise ability, and functional status of patients after traditional heart and thoracic surgery.But efficacy of home-based pulmonary rehabilitation for older adults following thoracoscopic surgery, it has not received much attention. This study employed a prospective, randomized, and controlled clinical design to determine the efficacy of home-based pulmonary rehabilitation in older adults after VATS. All participants underwent preoperative and initial postoperative pulmonary rehabilitation during their hospital stay and were randomly assigned to the experimental or control group at the time of discharge. The control group received standard health education, whereas the experimental group received home-based pulmonary rehabilitation in addition to standard health education. Objective and personal subjective outcome measurements were performed before hospital discharge and 2, 6, and 12 weeks after discharge The control group received standard care. Considering the principle for exercise progression, we divided the home-based rehabilitation program into two stages (0-2 weeks and 3-6 weeks).The exercise program was adjusted in the second week when patients visited the outpatient department of the hospital for follow-up. The home-based rehabilitation program included (1) breathing exercises (pursed-lip and diaphragmatic breathing) and coughing exercises, (2) aerobic exercises (upper and lower limb exercises and walking), (3) incentive spirometry training (Triflo-II), and (4) threshold load training of the inspiratory muscle. In the first stage (0-2 weeks), the aerobic exercise intensity was targeted to reach 10-11 points on the 20-point Borg rating of perceived exercise (RPE) scale. Patients raised their upper limbs while simultaneously performing lower-limb stepping at place for 20 min; in addition, they walked at a comfortable speed for 15 min twice per day. Incentive spirometry training (Triflo-II) was performed 8-10 times per hour. We used a threshold load trainer for inspiratory muscle training (30 breaths each time, twice per day) with the initial pressure set at 25%-30% of the maximum inspiratory pressure. In the second stage (3-6 weeks), the aerobic exercise intensity was targeted to reach 12-15 points on the RPE scale. Patients performed upper-limb resistance exercise (raising of a 250-cc water bottle) and lower-limb stepping for 20 min per day as well as walking exercise (slow walking for 5 min and fast walking for 2 min, followed by 5-min slow walking, for a total of 30 min). Incentive spirometry training (Triflo-II) was performed 8-10 times per hour, and a threshold load trainer was used to train the inspiratory muscle (30 breaths each time, twice per day), with the pressure intensity adjusted to more than 5% of that in the first stage.Researchers contacted patients at home every week through phone calls to monitor the occurrence of any uncomfortable reaction and to encourage patients to continue their rehabilitation program.
Interventions
(1) breathing exercises (pursed-lip and diaphragmatic breathing) and coughing exercises, (2) aerobic exercises (upper and lower limb exercises and walking), (3) incentive spirometry training (Triflo-II), and (4) threshold load training of the inspiratory muscle. In the first stage (0-2 weeks), the aerobic exercise intensity was targeted to reach 10-11 points on the 20-point Borg rating of perceived exercise (RPE) scale. Patients raised their upper limbs while simultaneously performing lower-limb stepping at place for 20 min; in addition, they walked at a comfortable speed for 15 min twice per day. Incentive spirometry training (Triflo-II) was performed 8-10 times per hour. We used a threshold load trainer for inspiratory muscle training (30 breaths each time, twice per day) with the initial pressure set at 25%-30% of the maximum inspiratory pressure.
Sponsors
Chang Gung Memorial Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Masking description
After participants signed the consent form, they were randomly included into the control or experimental group on the day of discharge
Intervention model description
This study employed a prospective, randomized, and controlled clinical design to determine the efficacy of home-based pulmonary rehabilitation in patients after thoracoscopy. After participants signed the consent form, they were randomly included into the control or experimental group on the day of discharge. The random assignment was performed based on simple randomization by using numbers from 1 to 36; numbered, sealed, opaque envelopes were used for allocation concealment. These envelopes were randomly distributed by non researchers and recorded.
Eligibility
Sex/Gender
ALL
Age
65 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
1. Signed consent 2. The men and women over the age of 65 3. admission to undergo VATS. 4. consciousness and ability to communicate 5. ability to undergo 6 weeks of a home-based pulmonary rehabilitation program
Exclusion criteria
1. refusal to participate 2. unplanned emergency surgery 3. hemodynamic instability 4. received other surgery within a month postsurgery 5. unconsciousness after surgery 6. bedridden and upper or lower limb weakness 7. received radiation and chemotherapy postsurgery 8. implementation of thoracoscopic surgery for biopsy only
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Discharge 2weeks Exercise Capacity | assessed at discharge 2weeks | Exercise capacity as assessed by 6 min walking test(M).The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise . The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions .The normal range in aged patients 60-69 y(male 572 m,female 538 M),70-79 y(male 527 m,female 471 M),80-89 y(male 417 m,female 392 M)higher scores mean a better outcome. |
| Discharge 6 Weeks Exercise Capacity | assessed at discharge.6weeks | Exercise capacity as assessed by 6 min walking test(M).The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise . The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions .The normal range in aged patients 60-69 y(male 572 m,female 538 M),70-79 y(male 527 m,female 471 M),80-89 y(male 417 m,female 392 M)higher scores mean a better outcome. |
| Discharge 12 Weeks Exercise Capacity | assessed at discharge 12 weeks | Exercise capacity as assessed by 6 min walking test(M).The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise . The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions .The normal range in aged patients 60-69 y(male 572 m,female 538 M),70-79 y(male 527 m,female 471 M),80-89 y(male 417 m,female 392 M).higher scores mean a better outcome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Discharge 2weeks Peak Expiratory Flow Rate(PEFR , Liter(L)/Sec) | assessed at discharge 2weeks | Peak expiratory flow rate (PEFR in liter(L)/sec) assessment by pulmonary function test.It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak expiratory flow is typically measured in units of liters per second (L/sec).when measured as part of spirometry.The normal range 500-700 L/sec In men, for women, the normal range is 380-500 L/sec.higher scores mean a better outcome. |
| Discharge 2weeks Inspiratory Muscle Strength(MIP,cmH2O) | assessed at discharge 2 weeks. | Inspiratory muscle strength as assessed by Maximum inspiratory pressure (MIP, cmH2O).The MIP is a measure of inspiratory muscle strength produced by a sub-atmospheric pressure The normal.range of MIP in elderly people approximately 60 cm H2O for men and 40 cm H2O for women .An absolute MIP value of \< - 40 cm H2O is always abnormal,and higher scores was mean a better outcome. |
| Discharge 2weeks Expiratory Muscle Strength(MEP,cmH2O) | assessed at discharge 2 weeks | The Maximal Expiratory Pressure (MEP) are global measures of the maximal strength of the respiratory muscles.(MEP, cmH2O) .MEP is a supra-atmospheric pressure which can be developed in an effort of the abdominal and intercostal muscles.Expiratory muscle strength assesses extrathoracic muscle health.An absolute MEP value of \< 80 cmH2O is always abnormal, and higher scores mean a better outcome. |
| Discharge 2 Weeks Modified Borg Score | assessed at discharge 2 weeks | Dyspnea score as assessed by Modified Borg score, The literature review clearly showed that the Modified Borg score was a valid and reliable tool when used in pulmonary medicine and in exercise physiology studies.The scale used was perceived exertion adapted to be appropriate for measuring dyspnea. This consisted of a vertical scale labelled 0-10, with corresponding verbal expressions of progressively increasing perceived sensation intensity. It starts at number 0 that mean breathing is no difficulty at all and progresses through to number 10 that mean breathing difficulty is maximal.so higher scores mean a worse outcome |
| Discharge 2weeks Lung Expansion Capacity | assessed at discharge 2 weeks | Lung expansion capacity as assessed by incentive spirometry with the flow-oriented device( Triflow II,volume × seconds) (ml).Incentive spirometry that feedback respiratory training can improve respiratory function, endurance for exercise capacity,Wide flow rate range from 600 - 1200(volume × seconds) (ml).higher scores mean a better outcome. |
| Postoperative 2 Weeks Pulmonary Complications | at 2weeks after discharge | Pulmonary complication as assessed by Chest X-ray.pneumonia.lung collapse.atelectasis.emphysema and pleural effusion were collected.some patients have two pulmonary complications at the same time, such as emphysem and infiltration, so the total number is not necessarily equal to 18. |
| Discharge 6 Weeks Forced Vital Capacity(Liter(L)/Sec) | assessments at discharge 6 weeks | Forced vital capacity (FVC in (liter(L)/sec)) assessment by pulmonary function test.Normal values in healthy males aged 20-60 from 4.5-3.5 (liter(L)/sec),and for females from 3.25-2.5 (liter(L)/sec) ,and whether higher scores mean a better outcome. |
| Discharge 6 Weeks Forced Expiratory Volume in 1 Second (FEV1,Liter(L)/Sec) | assessed at discharge 6weeks | The Forced Expiratory Volume in 1 Second parameter measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. The Measured column represents the total volume exhaled during the first second, in liters. Normal values in healthy males aged 20-60 range from 4.5 to 3.5 liters, and normal values for females aged 20-60 range from 3.25 to 2.5 liters. The Predicted column compares the actual volume breathed out during the first second of your test to an average of the normal volume breathed out in 1 second for a person of the same gender, height, and age. This value is expressed as a percentage, with normal test values being between 80% and 120% of the average (predicted) values.and whether higher scores mean a better outcome. |
| Discharge 6weeks MMEF 25-75%(Liter(L)/Sec) | assessed at discharge 6 weeks | Forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration. It can be given at discrete times, generally defined by what fraction of the forced vital capacity (FVC) has been exhaled. The usual discrete intervals are 25%, 50% and 75%, usually 25-75% (FEF25-75%).Predicted normal values for FEF depend on age, sex, height, mass and ethnicity as well as the research study that they are based on assessment by pulmonary function test and higher scores mean a better outcome. |
| Discharge 6weeks Peak Expiratory Flow Rate(PEFR in Liter( L)/Sec) | assessed at discharge .6weeks | Peak expiratory flow rate (PEFR in liter(L)/sec) assessment by pulmonary function test.It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak expiratory flow is typically measured in units of liters per second (L/sec).when measured as part of spirometry.The normal range 500-700 L/sec In men, for women, the normal range is 380-500 L/sec.higher scores mean a better outcome. |
| Discharge 6 Weeks Inspiratory Muscle Strength(MIP,cmH2O) | assessed at discharge6 weeks. | Inspiratory muscle strength as assessed by Maximum inspiratory pressure (MIP, cmH2O).The MIP is a measure of inspiratory muscle strength produced by a sub-atmospheric pressure The normal.range of MIP in elderly people approximately 60 cm H2O for men and 40 cm H2O for women .An absolute MIP value of \< - 40 cm H2O is always abnormal,and higher scores was mean a better outcome. |
| Discharge 6weeks Expiratory Muscle Strength (MEP, cmH2O) | assessed at discharge 6 weeks | The Maximal Expiratory Pressure (MEP,cmH2O) are global measures of the maximal strength of the respiratory muscles.(MEP, cmH2O) .MEP is a supra-atmospheric pressure which can be developed in an effort of the abdominal and intercostal muscles.Expiratory muscle strength assesses extrathoracic muscle health.An absolute MEP value of \< 80 cm H2O is always abnormal, and higher scores mean a better outcome. |
| Discharge 2 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec) | assessments at 2 weeks after discharge | Forced vital capacity (FVC in L/sec) assessment by pulmonary function test.Normal values in healthy males aged 20-60 from 4.5-3.5 L/sec,and for females from 3.25-2.5 L/sec ,and whether higher scores mean a better outcome. |
| Discharge 6weeks Lung Expansion Capacity | assessed at discharge 6 weeks | Lung expansion capacity as assessed by incentive spirometry with the flow-oriented device( Triflow II,volume × seconds) (ml)).Incentive spirometry that feedback respiratory training can improve respiratory function, endurance for exercise capacity,Wide flow rate range from 600 - 1200(volume × seconds) (mL)c.higher scores mean a better outcome. |
| Postoperative 6weeks Pulmonary Complications | at 6weeks after discharge | Pulmonary complication as assessed by Chest X-ray.pneumonia.lung collapse.atelectasis.emphysema and pleural effusion were collected.In our research,some patients have two pulmonary complications at the same time, such as emphysem and infiltration, so the total number is not necessarily equal to 18. |
| Discharge 12 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec ) | assessments at discharge 12 weeks | Forced vital capacity (FVC in (liter(L)/sec)) assessment by pulmonary function test.Normal values in healthy males aged 20-60 from 4.5-3.5 (liter(L)/sec),and for females from 3.25-2.5 (liter(L)/sec) ,and whether higher scores mean a better outcome. |
| Discharge 12 Weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec) | assessed at discharge12weeks | The Forced Expiratory Volume in 1 Second parameter(FEV1,liter(L)/sec) measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. The Measured column represents the total volume exhaled during the first second, in liters. Normal values in healthy males aged 20-60 range from 4.5 to 3.5 liters, and normal values for females aged 20-60 range from 3.25 to 2.5 liters. The Predicted column compares the actual volume breathed out during the first second of your test to an average of the normal volume breathed out in 1 second for a person of the same gender, height, and age. This value is expressed as a percentage, with normal test values being between 80% and 120% of the average (predicted) values.and whether higher scores mean a better outcome. |
| Discharge 12 Weeks MMEF 25-75%(Liter(L)/Sec) | assessed at discharge12weeks | Forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration. It can be given at discrete times, generally defined by what fraction of the forced vital capacity (FVC) has been exhaled. The usual discrete intervals are 25%, 50% and 75%, usually 25-75% (FEF25-75%).Predicted normal values for FEF depend on age, sex, height, mass and ethnicity as well as the research study that they are based on assessment by pulmonary function test and higher scores mean a better outcome. |
| Discharge 12 Weeks Peak Expiratory Flow Rate (PEFR in Liter(L)/Sec) | assessed at discharge 12 weeks | Peak expiratory flow rate (PEFR in liter(L)/sec) assessment by pulmonary function test.It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak expiratory flow is typically measured in units of liters per second (L/sec).when measured as part of spirometry.The normal range 500-700 L/sec In men, for women, the normal range is 380-500 L/sec.higher scores mean a better outcome. |
| Discharge 12 Weeks Inspiratory Muscle Strength (MIP,cmH2O) | assessed at discharge12 weeks. | Inspiratory muscle strength as assessed by Maximum inspiratory pressure (MIP, cmH2O).The MIP is a measure of inspiratory muscle strength produced by a sub-atmospheric pressure The normal.range of MIP in elderly people approximately 60 cm H2O for men and 40 cm H2O for women .An absolute MIP value of \< - 40 cm H2O is always abnormal,and higher scores was mean a better outcome. |
| Discharge 12weeks Expiratory Muscle Strength(MEP,cmH2O) | assessed at discharge 12weeks | The Maximal Expiratory Pressure (MEP,cmH2O) are global measures of the maximal strength of the respiratory muscles.(MEP, cmH2O) .MEP is a supra-atmospheric pressure which can be developed in an effort of the abdominal and intercostal muscles.Expiratory muscle strength assesses extrathoracic muscle health.An absolute MEP value of \< 80 cm H2O is always abnormal, and higher scores mean a better outcome. |
| Discharge 12 Weeks Modified Borg Score | assessed at discharge12weeks | Dyspnea score as assessed by Modified Borg score, The literature review clearly showed that the Modified Borg score was a valid and reliable tool when used in pulmonary medicine and in exercise physiology studies.The scale used was perceived exertion adapted to be appropriate for measuring dyspnea. This consisted of a vertical scale labelled 0-10, with corresponding verbal expressions of progressively increasing perceived sensation intensity. It starts at number 0 that mean breathing is no difficulty at all and progresses through to number 10 that mean breathing difficulty is maximal.so higher scores mean a worse outcome |
| Discharge 12 Weeks Lung Expansion Capacity | assessed at discharge 12weeks | Lung expansion capacity as assessed by incentive spirometry with the flow-oriented device( Triflow II,volume × seconds) (ml)).Incentive spirometry that feedback respiratory training can improve respiratory function, endurance for exercise capacity,Wide flow rate range from 600 - 1200(volume × seconds) (mL)c.higher scores mean a better outcome. |
| Postoperative 12 Weeks Pulmonary Complications | at 12 weeks after discharge | Pulmonary complication as assessed by Chest X-ray.pneumonia.lung collapse.atelectasis.emphysema and pleural effusion were collected.some patients have two pulmonary complications at the same time, such as emphysem and infiltration, so the total number is not necessarily equal to 18. |
| Discharge 6 Weeks Modified Borg Score | assessed at discharge 6week | Dyspnea score as assessed by Modified Borg score, The literature review clearly showed that the Modified Borg score was a valid and reliable tool when used in pulmonary medicine and in exercise physiology studies.The scale used was perceived exertion adapted to be appropriate for measuring dyspnea. This consisted of a vertical scale labelled 0-10, with corresponding verbal expressions of progressively increasing perceived sensation intensity. It starts at number 0 that mean breathing is no difficulty at all and progresses through to number 10 that mean breathing difficulty is maximal.so higher scores mean a worse outcome |
| Discharge 2weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec) | assessed at 2 weeks after discharge | The Forced Expiratory Volume in 1 Second parameter measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. The Measured column represents the total volume exhaled during the first second, in liters. Normal values in healthy males aged 20-60 range from 4.5 to 3.5 liters, and normal values for females aged 20-60 range from 3.25 to 2.5 liters. The Predicted column compares the actual volume breathed out during the first second of your test to an average of the normal volume breathed out in 1 second for a person of the same gender, height, and age. This value is expressed as a percentage, with normal test values being between 80% and 120% of the average (predicted) values.and whether higher scores mean a better outcome. |
| Discharge 2weeks MMEF 25-75%(Liter(L)/Sec) | assessed at discharge 2weeks | Forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration. It can be given at discrete times, generally defined by what fraction of the forced vital capacity (FVC) has been exhaled. The usual discrete intervals are 25%, 50% and 75%, usually 25-75% (FEF25-75%).Predicted normal values for FEF depend on age, sex, height, mass and ethnicity as well as the research study that they are based on assessment by pulmonary function test and higher scores mean a better outcome. |
Countries
Taiwan
Participant flow
Recruitment details
The study was design a Prospective randomized control trial,and enrolled a total of 36 older patients with lung tumors after thoracoscopic surgery in the cardiothoracic and vascular ordinary ward between March 31 2016 to April 1 2017. The study was performed conducted in Kaohsiung Chang Gung Memorial Hospital, Taiwan
Participants by arm
| Arm | Count |
|---|---|
| Pulmonary Rehabilitation Group arm group accept the pulmonary rehabilitation( smoking cession before operation, breathing exercise, extremities exercise, breathing muscle training, incentive spirometry (Triflo-II) training, intermittent positive pressure ventilation, chest physical therapy and pain control) in operation stage on before op-day 3 day and after op-day 2 weeks and keep home based pulmonary rehabilitation on discharge 2 weeks, 6 weeks and after 12 weeks. | 18 |
| The Control Group The control group received pain medication and usual care. | 18 |
| Total | 36 |
Baseline characteristics
| Characteristic | Total | The Control Group | Pulmonary Rehabilitation Group |
|---|---|---|---|
| 6-min walk test(meter,M) | 339.78 meter STANDARD_DEVIATION 54.62 | 315.22 meter STANDARD_DEVIATION 59.34 | 364.33 meter STANDARD_DEVIATION 49.89 |
| Age, Categorical Count of Participants <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Count of Participants >=65 years | 36 Participants | 18 Participants | 18 Participants |
| Age, Categorical Count of Participants Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants |
| American Society of Anesthesiologists (ASA) score | 2.11 scores on a scale STANDARD_DEVIATION 0.45 | 2.11 scores on a scale STANDARD_DEVIATION 0.58 | 2.11 scores on a scale STANDARD_DEVIATION 0.32 |
| Amount of comorbidities Cardiovascular diseases n | 6 Participants | 4 Participants | 2 Participants |
| Amount of comorbidities COPD | 11 Participants | 2 Participants | 9 Participants |
| Amount of comorbidities DM | 9 Participants | 4 Participants | 5 Participants |
| Amount of comorbidities Hypertension | 18 Participants | 11 Participants | 7 Participants |
| Anesthesia time(min) | 260.5 min STANDARD_DEVIATION 77.18 | 249.84 min STANDARD_DEVIATION 70.83 | 271.15 min STANDARD_DEVIATION 83.52 |
| BMI (Kg/m2) | 24.27 Kg/m2 STANDARD_DEVIATION 3.05 | 23.46 Kg/m2 STANDARD_DEVIATION 2.8 | 25.08 Kg/m2 STANDARD_DEVIATION 3.3 |
| BW (kg) | 61.66 kg STANDARD_DEVIATION 10.57 | 57.98 kg STANDARD_DEVIATION 9.44 | 65.33 kg STANDARD_DEVIATION 11.71 |
| chest tube placement time(hours) | 116.58 hours STANDARD_DEVIATION 44.23 | 118.11 hours STANDARD_DEVIATION 50.9 | 115.05 hours STANDARD_DEVIATION 37.56 |
| FEV1/FVC(%) | 80.03 % STANDARD_DEVIATION 13.73 | 81.03 % STANDARD_DEVIATION 10.45 | 79.02 % STANDARD_DEVIATION 17.01 |
| Lung capacity (mL/sec) | 1100.00 mL STANDARD_DEVIATION 529.68 | 1000.00 mL STANDARD_DEVIATION 524.68 | 1200.00 mL STANDARD_DEVIATION 534.68 |
| MEP(cmH2O) | 56.15 cmH20 STANDARD_DEVIATION 23.36 | 50.40 cmH20 STANDARD_DEVIATION 21.06 | 61.89 cmH20 STANDARD_DEVIATION 24 |
| MIP(cmH2O) | 49.98 cmH2O STANDARD_DEVIATION 13.82 | 49.73 cmH2O STANDARD_DEVIATION 16.83 | 50.22 cmH2O STANDARD_DEVIATION 11.89 |
| Modified Borg score | 1.75 scores on a scale STANDARD_DEVIATION 0.59 | 1.89 scores on a scale STANDARD_DEVIATION 0.58 | 1.61 scores on a scale STANDARD_DEVIATION 0.6 |
| PFT FEV1(liter/sec) | 1.83 liter/sec STANDARD_DEVIATION 0.69 | 1.78 liter/sec STANDARD_DEVIATION 0.93 | 1.88 liter/sec STANDARD_DEVIATION 0.44 |
| PFT FVC(liter/sec) | 1.45 liter/sec STANDARD_DEVIATION 0.59 | 1.43 liter/sec STANDARD_DEVIATION 0.71 | 1.48 liter/sec STANDARD_DEVIATION 0.47 |
| PFT MMEF25-75(liter/sec) | 1.61 liter/sec STANDARD_DEVIATION 0.97 | 1.41 liter/sec STANDARD_DEVIATION 0.77 | 1.80 liter/sec STANDARD_DEVIATION 1.17 |
| PFT PEFR(liter/sec) | 3.55 liter/sec STANDARD_DEVIATION 1.76 | 3.01 liter/sec STANDARD_DEVIATION 1.46 | 4.08 liter/sec STANDARD_DEVIATION 2.05 |
| postoperative complications air leak | 12 Participants | 6 Participants | 6 Participants |
| postoperative complications emphysema | 31 Participants | 15 Participants | 16 Participants |
| postoperative diagnosis adenocarcinoma | 27 Participants | 13 Participants | 14 Participants |
| postoperative diagnosis benign lung tumor | 4 Participants | 2 Participants | 2 Participants |
| postoperative diagnosis large cell carcinoma | 1 Participants | 0 Participants | 1 Participants |
| postoperative diagnosis sguamous cell carcinoma | 3 Participants | 3 Participants | 0 Participants |
| postoperative diagnosis small cell carcinoma | 1 Participants | 0 Participants | 1 Participants |
| postoperative stages of lung cancer Benign lung tumor(%) | 4 Participants | 2 Participants | 2 Participants |
| postoperative stages of lung cancer others,ground-glass opacity(%) | 2 Participants | 1 Participants | 1 Participants |
| postoperative stages of lung cancer stage1 n(%) | 19 Participants | 8 Participants | 11 Participants |
| postoperative stages of lung cancer stage2 n(%) | 11 Participants | 7 Participants | 4 Participants |
| Race and Ethnicity Not Collected | 0 Participants | — | — |
| Region of Enrollment Taiwan | 36 Participants | 18 Participants | 18 Participants |
| Sex: Female, Male Female | 19 Participants | 11 Participants | 8 Participants |
| Sex: Female, Male Male | 17 Participants | 7 Participants | 10 Participants |
| smoking | 10 Participants | 4 Participants | 6 Participants |
| surgery method lobectomy | 23 Participants | 12 Participants | 11 Participants |
| surgery method sefmentectomy | 3 Participants | 1 Participants | 2 Participants |
| surgery method wedge resection | 10 Participants | 5 Participants | 5 Participants |
| surgery site left low lobe | 4 Participants | 1 Participants | 3 Participants |
| surgery site left upper lobe | 5 Participants | 5 Participants | 0 Participants |
| surgery site Right low lobe | 7 Participants | 4 Participants | 3 Participants |
| surgery site Right middle lobe | 2 Participants | 1 Participants | 1 Participants |
| surgery site Right upper lobe | 19 Participants | 7 Participants | 12 Participants |
| Surgery time(min) | 231.08 min STANDARD_DEVIATION 72.67 | 225.26 min STANDARD_DEVIATION 66.32 | 236.90 min STANDARD_DEVIATION 79.02 |
| total hospital days | 8.5 days STANDARD_DEVIATION 3.85 | 8.32 days STANDARD_DEVIATION 3.28 | 8.68 days STANDARD_DEVIATION 4.41 |
| wedge resection | 10 Participants | 5 Participants | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 18 | 0 / 18 |
| other Total, other adverse events | 6 / 18 | 6 / 18 |
| serious Total, serious adverse events | 0 / 18 | 0 / 18 |
Outcome results
Primary
Discharge 12 Weeks Exercise Capacity
Exercise capacity as assessed by 6 min walking test(M).The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise . The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions .The normal range in aged patients 60-69 y(male 572 m,female 538 M),70-79 y(male 527 m,female 471 M),80-89 y(male 417 m,female 392 M).higher scores mean a better outcome.
Time frame: assessed at discharge 12 weeks
Population: 2-WAY repeated measures ANOVA method was used for exercise capacity. For group comparisons, an intention-to-treat analysis was performed. group × time interactions were observed for the 6-min walking distance.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Exercise Capacity | 397.06 meter(M) | Standard Deviation 50.37 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Exercise Capacity | 345.17 meter(M) | Standard Deviation 46.04 |
p-value: <0.05ANOVA
Primary
Discharge 2weeks Exercise Capacity
Exercise capacity as assessed by 6 min walking test(M).The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise . The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions .The normal range in aged patients 60-69 y(male 572 m,female 538 M),70-79 y(male 527 m,female 471 M),80-89 y(male 417 m,female 392 M)higher scores mean a better outcome.
Time frame: assessed at discharge 2weeks
Population: 2-WAY repeated measures ANOVA method was used for exercise capacity.an intention-to-treat analysis was performed.group × time interactions were observed for the 6-min walking distance.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks Exercise Capacity | 408.61 meter(M) | Standard Deviation 62.85 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks Exercise Capacity | 311.94 meter(M) | Standard Deviation 84.65 |
p-value: <0.05ANOVA
Primary
Discharge 6 Weeks Exercise Capacity
Exercise capacity as assessed by 6 min walking test(M).The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. The 6-minute walk distance (6 MWD) provides a measure for integrated global response of multiple cardiopulmonary and musculoskeletal systems involved in exercise . The 6 MWT provides information regarding functional capacity, response to therapy and prognosis across a broad range of chronic cardiopulmonary conditions .The normal range in aged patients 60-69 y(male 572 m,female 538 M),70-79 y(male 527 m,female 471 M),80-89 y(male 417 m,female 392 M)higher scores mean a better outcome.
Time frame: assessed at discharge.6weeks
Population: 2-WAY repeated measures ANOVA method was used for exercise capacity. For group comparisons, an intention-to-treat analysis was performed.group × time interactions were observed for the 6-min walking distance.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6 Weeks Exercise Capacity | 411.63 meter(M) | Standard Deviation 44.49 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6 Weeks Exercise Capacity | 332.94 meter(M) | Standard Deviation 54.03 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 12weeks Expiratory Muscle Strength(MEP,cmH2O)
The Maximal Expiratory Pressure (MEP,cmH2O) are global measures of the maximal strength of the respiratory muscles.(MEP, cmH2O) .MEP is a supra-atmospheric pressure which can be developed in an effort of the abdominal and intercostal muscles.Expiratory muscle strength assesses extrathoracic muscle health.An absolute MEP value of \< 80 cm H2O is always abnormal, and higher scores mean a better outcome.
Time frame: assessed at discharge 12weeks
Population: Two-way repeated measures ANOVA for MEP. an intention-to-treat analysis was performed.group × time interactions were observed for the MEP
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12weeks Expiratory Muscle Strength(MEP,cmH2O) | 92.56 cmH2O | Standard Deviation 34.37 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12weeks Expiratory Muscle Strength(MEP,cmH2O) | 74.48 cmH2O | Standard Deviation 18.64 |
p-value: <0.05ANOVA
Secondary
Discharge 12 Weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec)
The Forced Expiratory Volume in 1 Second parameter(FEV1,liter(L)/sec) measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. The Measured column represents the total volume exhaled during the first second, in liters. Normal values in healthy males aged 20-60 range from 4.5 to 3.5 liters, and normal values for females aged 20-60 range from 3.25 to 2.5 liters. The Predicted column compares the actual volume breathed out during the first second of your test to an average of the normal volume breathed out in 1 second for a person of the same gender, height, and age. This value is expressed as a percentage, with normal test values being between 80% and 120% of the average (predicted) values.and whether higher scores mean a better outcome.
Time frame: assessed at discharge12weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec) | 1.85 liter(L)/sec | Standard Deviation 0.45 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec) | 1.74 liter(L)/sec | Standard Deviation 0.72 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 12 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec )
Forced vital capacity (FVC in (liter(L)/sec)) assessment by pulmonary function test.Normal values in healthy males aged 20-60 from 4.5-3.5 (liter(L)/sec),and for females from 3.25-2.5 (liter(L)/sec) ,and whether higher scores mean a better outcome.
Time frame: assessments at discharge 12 weeks
Population: .2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec ) | 2.32 liter( L)/sec | Standard Deviation 0.72 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec ) | 2.16 liter( L)/sec | Standard Deviation 0.96 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 12 Weeks Inspiratory Muscle Strength (MIP,cmH2O)
Inspiratory muscle strength as assessed by Maximum inspiratory pressure (MIP, cmH2O).The MIP is a measure of inspiratory muscle strength produced by a sub-atmospheric pressure The normal.range of MIP in elderly people approximately 60 cm H2O for men and 40 cm H2O for women .An absolute MIP value of \< - 40 cm H2O is always abnormal,and higher scores was mean a better outcome.
Time frame: assessed at discharge12 weeks.
Population: Two-way repeated measures ANOVA for MIP. an intention-to-treat analysis was performed.group × time interactions were observed for the MIP
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Inspiratory Muscle Strength (MIP,cmH2O) | 91.11 cmH2O | Standard Deviation 30.46 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Inspiratory Muscle Strength (MIP,cmH2O) | 64.67 cmH2O | Standard Deviation 20.3 |
Secondary
Discharge 12 Weeks Lung Expansion Capacity
Lung expansion capacity as assessed by incentive spirometry with the flow-oriented device( Triflow II,volume × seconds) (ml)).Incentive spirometry that feedback respiratory training can improve respiratory function, endurance for exercise capacity,Wide flow rate range from 600 - 1200(volume × seconds) (mL)c.higher scores mean a better outcome.
Time frame: assessed at discharge 12weeks
Population: Two-way repeated measures ANOVA for Lung expansion capacity. an intention-to-treat analysis was performed.group × time interactions were observed for the Lung expansion capacity
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Lung Expansion Capacity | 1406.67 (ml) | Standard Deviation 798.2 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Lung Expansion Capacity | 1150.33 (ml) | Standard Deviation 345.13 |
p-value: <0.05ANOVA
Secondary
Discharge 12 Weeks MMEF 25-75%(Liter(L)/Sec)
Forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration. It can be given at discrete times, generally defined by what fraction of the forced vital capacity (FVC) has been exhaled. The usual discrete intervals are 25%, 50% and 75%, usually 25-75% (FEF25-75%).Predicted normal values for FEF depend on age, sex, height, mass and ethnicity as well as the research study that they are based on assessment by pulmonary function test and higher scores mean a better outcome.
Time frame: assessed at discharge12weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks MMEF 25-75%(Liter(L)/Sec) | 2.44 liter(L)/sec | Standard Deviation 1.5 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks MMEF 25-75%(Liter(L)/Sec) | 1.85 liter(L)/sec | Standard Deviation 0.76 |
p-value: <0.05ANOVA
Secondary
Discharge 12 Weeks Modified Borg Score
Dyspnea score as assessed by Modified Borg score, The literature review clearly showed that the Modified Borg score was a valid and reliable tool when used in pulmonary medicine and in exercise physiology studies.The scale used was perceived exertion adapted to be appropriate for measuring dyspnea. This consisted of a vertical scale labelled 0-10, with corresponding verbal expressions of progressively increasing perceived sensation intensity. It starts at number 0 that mean breathing is no difficulty at all and progresses through to number 10 that mean breathing difficulty is maximal.so higher scores mean a worse outcome
Time frame: assessed at discharge12weeks
Population: Two-way repeated measures ANOVA for Modified Borg score. an intention-to-treat analysis was performed.group × time interactions were observed for the Modified Borg score
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Modified Borg Score | 0.70 scores on a scale | Standard Deviation 0.83 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Modified Borg Score | 1.05 scores on a scale | Standard Deviation 0.92 |
p-value: <0.05ANOVA
Secondary
Discharge 12 Weeks Peak Expiratory Flow Rate (PEFR in Liter(L)/Sec)
Peak expiratory flow rate (PEFR in liter(L)/sec) assessment by pulmonary function test.It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak expiratory flow is typically measured in units of liters per second (L/sec).when measured as part of spirometry.The normal range 500-700 L/sec In men, for women, the normal range is 380-500 L/sec.higher scores mean a better outcome.
Time frame: assessed at discharge 12 weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 12 Weeks Peak Expiratory Flow Rate (PEFR in Liter(L)/Sec) | 4.94 liter(L)/sec | Standard Deviation 1.46 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 12 Weeks Peak Expiratory Flow Rate (PEFR in Liter(L)/Sec) | 4.78 liter(L)/sec | Standard Deviation 2.25 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 2weeks Expiratory Muscle Strength(MEP,cmH2O)
The Maximal Expiratory Pressure (MEP) are global measures of the maximal strength of the respiratory muscles.(MEP, cmH2O) .MEP is a supra-atmospheric pressure which can be developed in an effort of the abdominal and intercostal muscles.Expiratory muscle strength assesses extrathoracic muscle health.An absolute MEP value of \< 80 cmH2O is always abnormal, and higher scores mean a better outcome.
Time frame: assessed at discharge 2 weeks
Population: Two-way repeated measures ANOVA for MEP. an intention-to-treat analysis was performed.group × time interactions were observed for the MEP
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks Expiratory Muscle Strength(MEP,cmH2O) | 89.44 cmH2O | Standard Deviation 28.79 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks Expiratory Muscle Strength(MEP,cmH2O) | 68.89 cmH2O | Standard Deviation 22.72 |
p-value: <0.05ANOVA
Secondary
Discharge 2weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec)
The Forced Expiratory Volume in 1 Second parameter measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. The Measured column represents the total volume exhaled during the first second, in liters. Normal values in healthy males aged 20-60 range from 4.5 to 3.5 liters, and normal values for females aged 20-60 range from 3.25 to 2.5 liters. The Predicted column compares the actual volume breathed out during the first second of your test to an average of the normal volume breathed out in 1 second for a person of the same gender, height, and age. This value is expressed as a percentage, with normal test values being between 80% and 120% of the average (predicted) values.and whether higher scores mean a better outcome.
Time frame: assessed at 2 weeks after discharge
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec) | 1.97 liter(L)/sec | Standard Deviation 0.54 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks Forced Expiratory Volume in 1 Second(FEV1,Liter(L)/Sec) | 1.57 liter(L)/sec | Standard Deviation 0.69 |
p-value: <0.05ANOVA
Secondary
Discharge 2 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec)
Forced vital capacity (FVC in L/sec) assessment by pulmonary function test.Normal values in healthy males aged 20-60 from 4.5-3.5 L/sec,and for females from 3.25-2.5 L/sec ,and whether higher scores mean a better outcome.
Time frame: assessments at 2 weeks after discharge
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec) | 2.48 liter(L)/sec | Standard Deviation 0.8 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2 Weeks Forced Vital Capacity (FVC in Liter(L)/Sec) | 2.00 liter(L)/sec | Standard Deviation 0.85 |
p-value: <0.05ANOVA
Secondary
Discharge 2weeks Inspiratory Muscle Strength(MIP,cmH2O)
Inspiratory muscle strength as assessed by Maximum inspiratory pressure (MIP, cmH2O).The MIP is a measure of inspiratory muscle strength produced by a sub-atmospheric pressure The normal.range of MIP in elderly people approximately 60 cm H2O for men and 40 cm H2O for women .An absolute MIP value of \< - 40 cm H2O is always abnormal,and higher scores was mean a better outcome.
Time frame: assessed at discharge 2 weeks.
Population: Two-way repeated measures ANOVA for MIP. For group comparisons, an intention-to-treat analysis was performed. group × time interactions were observed for the MIP
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks Inspiratory Muscle Strength(MIP,cmH2O) | 90.00 cmH2O | Standard Deviation 25.66 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks Inspiratory Muscle Strength(MIP,cmH2O) | 67.33 cmH2O | Standard Deviation 28.15 |
p-value: <0.05ANOVA
Secondary
Discharge 2weeks Lung Expansion Capacity
Lung expansion capacity as assessed by incentive spirometry with the flow-oriented device( Triflow II,volume × seconds) (ml).Incentive spirometry that feedback respiratory training can improve respiratory function, endurance for exercise capacity,Wide flow rate range from 600 - 1200(volume × seconds) (ml).higher scores mean a better outcome.
Time frame: assessed at discharge 2 weeks
Population: Two-way repeated measures ANOVA for Lung expansion capacity. an intention-to-treat analysis was performed.group × time interactions were observed for the Lung expansion capacity.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks Lung Expansion Capacity | 1450.00 (ml) | Standard Deviation 619.53 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks Lung Expansion Capacity | 1033.33 (ml) | Standard Deviation 388.65 |
p-value: <0.05ANOVA
Secondary
Discharge 2weeks MMEF 25-75%(Liter(L)/Sec)
Forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration. It can be given at discrete times, generally defined by what fraction of the forced vital capacity (FVC) has been exhaled. The usual discrete intervals are 25%, 50% and 75%, usually 25-75% (FEF25-75%).Predicted normal values for FEF depend on age, sex, height, mass and ethnicity as well as the research study that they are based on assessment by pulmonary function test and higher scores mean a better outcome.
Time frame: assessed at discharge 2weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks MMEF 25-75%(Liter(L)/Sec) | 2.00 liter(L)/sec | Standard Deviation 0.81 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks MMEF 25-75%(Liter(L)/Sec) | 1.58 liter(L)/sec | Standard Deviation 0.94 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 2 Weeks Modified Borg Score
Dyspnea score as assessed by Modified Borg score, The literature review clearly showed that the Modified Borg score was a valid and reliable tool when used in pulmonary medicine and in exercise physiology studies.The scale used was perceived exertion adapted to be appropriate for measuring dyspnea. This consisted of a vertical scale labelled 0-10, with corresponding verbal expressions of progressively increasing perceived sensation intensity. It starts at number 0 that mean breathing is no difficulty at all and progresses through to number 10 that mean breathing difficulty is maximal.so higher scores mean a worse outcome
Time frame: assessed at discharge 2 weeks
Population: Two-way repeated measures ANOVA for Modified Borg score.an intention-to-treat analysis was performed.group × time interactions were observed for the Modified Borg score
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2 Weeks Modified Borg Score | 1.06 scores on a scale | Standard Deviation 0.54 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2 Weeks Modified Borg Score | 1.72 scores on a scale | Standard Deviation 0.67 |
p-value: <0.05ANOVA
Secondary
Discharge 2weeks Peak Expiratory Flow Rate(PEFR , Liter(L)/Sec)
Peak expiratory flow rate (PEFR in liter(L)/sec) assessment by pulmonary function test.It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak expiratory flow is typically measured in units of liters per second (L/sec).when measured as part of spirometry.The normal range 500-700 L/sec In men, for women, the normal range is 380-500 L/sec.higher scores mean a better outcome.
Time frame: assessed at discharge 2weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 2weeks Peak Expiratory Flow Rate(PEFR , Liter(L)/Sec) | 5.68 liter(L)/sec | Standard Deviation 2.35 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 2weeks Peak Expiratory Flow Rate(PEFR , Liter(L)/Sec) | 4.27 liter(L)/sec | Standard Deviation 2.35 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 6weeks Expiratory Muscle Strength (MEP, cmH2O)
The Maximal Expiratory Pressure (MEP,cmH2O) are global measures of the maximal strength of the respiratory muscles.(MEP, cmH2O) .MEP is a supra-atmospheric pressure which can be developed in an effort of the abdominal and intercostal muscles.Expiratory muscle strength assesses extrathoracic muscle health.An absolute MEP value of \< 80 cm H2O is always abnormal, and higher scores mean a better outcome.
Time frame: assessed at discharge 6 weeks
Population: Two-way repeated measures ANOVA for MEP. an intention-to-treat analysis was performed.group × time interactions were observed for the MEP
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6weeks Expiratory Muscle Strength (MEP, cmH2O) | 93.89 cmH2O | Standard Deviation 30.7 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6weeks Expiratory Muscle Strength (MEP, cmH2O) | 76.67 cmH2O | Standard Deviation 23.51 |
p-value: <0.05ANOVA
Secondary
Discharge 6 Weeks Forced Expiratory Volume in 1 Second (FEV1,Liter(L)/Sec)
The Forced Expiratory Volume in 1 Second parameter measures the volume of air that was exhaled into the mouthpiece in the first second after a full inhalation. The Measured column represents the total volume exhaled during the first second, in liters. Normal values in healthy males aged 20-60 range from 4.5 to 3.5 liters, and normal values for females aged 20-60 range from 3.25 to 2.5 liters. The Predicted column compares the actual volume breathed out during the first second of your test to an average of the normal volume breathed out in 1 second for a person of the same gender, height, and age. This value is expressed as a percentage, with normal test values being between 80% and 120% of the average (predicted) values.and whether higher scores mean a better outcome.
Time frame: assessed at discharge 6weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6 Weeks Forced Expiratory Volume in 1 Second (FEV1,Liter(L)/Sec) | 2.02 liter(L)/sec | Standard Deviation 0.6 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6 Weeks Forced Expiratory Volume in 1 Second (FEV1,Liter(L)/Sec) | 1.58 liter(L)/sec | Standard Deviation 0.62 |
p-value: <0.05ANOVA
Secondary
Discharge 6 Weeks Forced Vital Capacity(Liter(L)/Sec)
Forced vital capacity (FVC in (liter(L)/sec)) assessment by pulmonary function test.Normal values in healthy males aged 20-60 from 4.5-3.5 (liter(L)/sec),and for females from 3.25-2.5 (liter(L)/sec) ,and whether higher scores mean a better outcome.
Time frame: assessments at discharge 6 weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6 Weeks Forced Vital Capacity(Liter(L)/Sec) | 2.48 liter( L)/sec | Standard Deviation 0.88 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6 Weeks Forced Vital Capacity(Liter(L)/Sec) | 1.97 liter( L)/sec | Standard Deviation 0.8 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Discharge 6 Weeks Inspiratory Muscle Strength(MIP,cmH2O)
Inspiratory muscle strength as assessed by Maximum inspiratory pressure (MIP, cmH2O).The MIP is a measure of inspiratory muscle strength produced by a sub-atmospheric pressure The normal.range of MIP in elderly people approximately 60 cm H2O for men and 40 cm H2O for women .An absolute MIP value of \< - 40 cm H2O is always abnormal,and higher scores was mean a better outcome.
Time frame: assessed at discharge6 weeks.
Population: Two-way repeated measures ANOVA for MIP. an intention-to-treat analysis was performed.group × time interactions were observed for the MIP
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6 Weeks Inspiratory Muscle Strength(MIP,cmH2O) | 93.33 cmH2O | Standard Deviation 34.47 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6 Weeks Inspiratory Muscle Strength(MIP,cmH2O) | 64.67 cmH2O | Standard Deviation 20.3 |
Secondary
Discharge 6weeks Lung Expansion Capacity
Lung expansion capacity as assessed by incentive spirometry with the flow-oriented device( Triflow II,volume × seconds) (ml)).Incentive spirometry that feedback respiratory training can improve respiratory function, endurance for exercise capacity,Wide flow rate range from 600 - 1200(volume × seconds) (mL)c.higher scores mean a better outcome.
Time frame: assessed at discharge 6 weeks
Population: Two-way repeated measures ANOVA for Lung expansion capacity. an intention-to-treat analysis was performed.group × time interactions were observed for the Lung expansion capacity
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6weeks Lung Expansion Capacity | 1683.33 (ml) | Standard Deviation 667.96 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6weeks Lung Expansion Capacity | 1116.63 (ml) | Standard Deviation 382.33 |
p-value: <0.05ANOVA
Secondary
Discharge 6weeks MMEF 25-75%(Liter(L)/Sec)
Forced expiratory flow (FEF) is the flow (or speed) of air coming out of the lung during the middle portion of a forced expiration. It can be given at discrete times, generally defined by what fraction of the forced vital capacity (FVC) has been exhaled. The usual discrete intervals are 25%, 50% and 75%, usually 25-75% (FEF25-75%).Predicted normal values for FEF depend on age, sex, height, mass and ethnicity as well as the research study that they are based on assessment by pulmonary function test and higher scores mean a better outcome.
Time frame: assessed at discharge 6 weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6weeks MMEF 25-75%(Liter(L)/Sec) | 2.12 liter(L)/sec | Standard Deviation 0.74 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6weeks MMEF 25-75%(Liter(L)/Sec) | 2.08 liter(L)/sec | Standard Deviation 1.46 |
p-value: <0.05ANOVA
Secondary
Discharge 6 Weeks Modified Borg Score
Dyspnea score as assessed by Modified Borg score, The literature review clearly showed that the Modified Borg score was a valid and reliable tool when used in pulmonary medicine and in exercise physiology studies.The scale used was perceived exertion adapted to be appropriate for measuring dyspnea. This consisted of a vertical scale labelled 0-10, with corresponding verbal expressions of progressively increasing perceived sensation intensity. It starts at number 0 that mean breathing is no difficulty at all and progresses through to number 10 that mean breathing difficulty is maximal.so higher scores mean a worse outcome
Time frame: assessed at discharge 6week
Population: Two-way repeated measures ANOVA for Modified Borg score.an intention-to-treat analysis was performed.group × time interactions were observed for the Modified Borg score
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6 Weeks Modified Borg Score | 0.75 scores on a scale | Standard Deviation 0.79 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6 Weeks Modified Borg Score | 1.11 scores on a scale | Standard Deviation 1.74 |
p-value: <0.05ANOVA
Secondary
Discharge 6weeks Peak Expiratory Flow Rate(PEFR in Liter( L)/Sec)
Peak expiratory flow rate (PEFR in liter(L)/sec) assessment by pulmonary function test.It measures the airflow through the bronchi and thus the degree of obstruction in the airways. Peak expiratory flow is typically measured in units of liters per second (L/sec).when measured as part of spirometry.The normal range 500-700 L/sec In men, for women, the normal range is 380-500 L/sec.higher scores mean a better outcome.
Time frame: assessed at discharge .6weeks
Population: 2-WAY repeated measures ANOVA method was used for pulmonary function test.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Discharge 6weeks Peak Expiratory Flow Rate(PEFR in Liter( L)/Sec) | 5.13 liter(L)/sec | Standard Deviation 1.5 |
| The Control Group 2weeks Six-min Walking Distanc | Discharge 6weeks Peak Expiratory Flow Rate(PEFR in Liter( L)/Sec) | 4.71 liter(L)/sec | Standard Deviation 2.13 |
Comparison: null hypothesisp-value: <0.05ANOVA
Secondary
Postoperative 12 Weeks Pulmonary Complications
Pulmonary complication as assessed by Chest X-ray.pneumonia.lung collapse.atelectasis.emphysema and pleural effusion were collected.some patients have two pulmonary complications at the same time, such as emphysem and infiltration, so the total number is not necessarily equal to 18.
Time frame: at 12 weeks after discharge
Population: Pearson chi-square test was used for Pulmonary complication on discharge 12 weeks .Data is presented as n(%).
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | atelectasis | 1 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | pleural effusion | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | emphysema | 1 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | pulmonary infilation | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | pneumonia | 0 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | pneumonia | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | pulmonary infilation | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | pleural effusion | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | atelectasis | 2 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 12 Weeks Pulmonary Complications | emphysema | 0 Participants |
Secondary
Postoperative 2 Weeks Pulmonary Complications
Pulmonary complication as assessed by Chest X-ray.pneumonia.lung collapse.atelectasis.emphysema and pleural effusion were collected.some patients have two pulmonary complications at the same time, such as emphysem and infiltration, so the total number is not necessarily equal to 18.
Time frame: at 2weeks after discharge
Population: Pearson chi-square test was used for Pulmonary complication on discharge 2 weeks .Data is presented as either n(%).
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | pneumonia | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | atelectasis | 1 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | pleural effusion | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | emphysema | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | pulmonary infilation | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | pulmonary infilation | 0 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | emphysema | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | atelectasis | 2 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | pneumonia | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 2 Weeks Pulmonary Complications | pleural effusion | 1 Participants |
Comparison: Descriptive statistics were expressed as mean ± standard deviation or median and interquartile range depending on the nature and distribution of the variablesp-value: 0.05Chi-squared
Secondary
Postoperative 6weeks Pulmonary Complications
Pulmonary complication as assessed by Chest X-ray.pneumonia.lung collapse.atelectasis.emphysema and pleural effusion were collected.In our research,some patients have two pulmonary complications at the same time, such as emphysem and infiltration, so the total number is not necessarily equal to 18.
Time frame: at 6weeks after discharge
Population: Pearson chi-square test was used for Pulmonary complication on discharge 6 weeks .Data is presented as n(%).
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | pneumonia | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | atelectasis | 0 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | pleural effusion | 3 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | emphysema | 5 Participants |
| Pulmonary Rehabilitation Group 2 Weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | pulmonary infilation | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | pulmonary infilation | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | pneumonia | 1 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | emphysema | 11 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | pleural effusion | 4 Participants |
| The Control Group 2weeks Six-min Walking Distanc | Postoperative 6weeks Pulmonary Complications | atelectasis | 2 Participants |
Comparison: null hypothesisp-value: <0.05Chi-squared