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Physical activity in surgical lung cancer patients: a systematic review

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Abstract

Purpose

Perioperative exercise could improve health outcomes of surgical lung cancer patients, but less is known about their natural physical activity (PA) behavior before exercise interventions. This review aimed to synthesize evidence on PA, regarding the following: (1) proportion of patients meeting PA guidelines, (2) amount of PA, (3) PA trajectory following surgery, and (4) correlates of PA before or after surgery.

Methods

We conducted a systematic review using PubMed, CINHAL, Scopus, and SPORTDiscus (July 2021). Observational or experimental studies that measure PA of lung cancer patients before/after surgery were included. We assessed methodological quality using the NIH Quality Assessment Tools and extracted data using a standardized form.

Results

Seventeen studies (25 articles, N = 1737 participants) published between 2009 and 2021 were included. Fourteen studies had sample sizes less than 100. Thirteen studies were of fair quality and four studies were of good quality. Only 23–28% of patients met PA guideline (150 min/week moderate-vigorous PA) at 6 months–6 years after surgery. Patients took an average of 3822–10,603 daily steps before surgery and 3934–8863 steps at 1–3 months after surgery. Physical activity was lower at 1 day–3 months after surgery, compared with preoperative levels. Perioperative PA was positively associated with exercise capacity, quality of life and reduced postoperative complications.

Conclusion

This review suggests that PA is low among surgical lung cancer patients, and it may not recover within 3 months following surgery. Physical activity has the potential to improve postoperative outcomes. However, the existing evidence is weak, and future larger longitudinal studies are needed.

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Authors and Affiliations

  1. School of Nursing, University of Michigan, Ann Arbor, MI, USA

    Weijiao Zhou, Philip T. Veliz & Janet L. Larson

  2. School of Nursing, Indiana University, Indianapolis, IN, USA

    Katelyn E. Webster

  3. School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA

    Ellen Lavoie Smith

  4. School of Kinesiology, University of Michigan, Ann Arbor, MI, USA

    Weiyun Chen

  5. Department of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA

    Rishindra M. Reddy

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  1. Weijiao Zhou
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  2. Katelyn E. Webster
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  4. Weiyun Chen
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  5. Philip T. Veliz
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  7. Janet L. Larson
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Contributions

WZ and JL had the idea for the article, WZ and KW performed the literature search and data extraction, WZ drafted the manuscript, WZ, JL, ES, WC, PV and RR revised the manuscript.

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Correspondence to Weijiao Zhou.

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Zhou, W., Webster, K.E., Smith, E.L. et al. Physical activity in surgical lung cancer patients: a systematic review. Support Care Cancer 30, 6473–6482 (2022). https://doi.org/10.1007/s00520-022-07018-1

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