Effect of graded exercise rehabilitation based on pulmonary function classification on dyspnea, pulmonary function, and exercise capacity in elderly lung cancer patients.

Abstract

Objective: To investigate the effects of graded exercise rehabilitation training tailored to pulmonary function classification on dyspnea, pulmonary function, and exercise capacity during postoperative rehabilitation in elderly patients following lung cancer surgery.

Methods: A retrospective analysis was conducted on clinical data from 168 elderly patients undergoing postoperative rehabilitation after lung cancer surgery at Panjin Liaohe Oilfield Gem Flower Hospital from January 2021 to December 2022. Patients were divided into two groups based on the rehabilitation received: the control group (n=71), receiving standard rehabilitation, and the study group (n=97), receiving additional graded exercise rehabilitation based on pulmonary function classification. Outcomes were compared before and after a 12-week intervention, including psychological status (Hamilton Anxiety Scale (HAMA) and Hamilton Depression Rating Scale (HAMD)), symptom scores, dyspnea (Modified Medical Research Council (mMRC) and St. George's Respiratory Questionnaire (SGRQ) scores), pulmonary function (Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), Peak Expiratory Flow (PEF), Maximum Voluntary Ventilation (MVV), and respiratory muscle strength), inflammatory markers (Interleukin-8 (IL-8)), tumor markers (Carcinoembryonic Antigen (CEA) and Cytokeratin-19 Fragment antigen 21-1 (CYFRA21-1)), exercise capacity (6-minute walk test (6MWT) distance, Maximum Oxygen Consumption (VO₂max), Maximum Workload (MWL), and Anaerobic Threshold (AT)), sleep quality (Pittsburgh Sleep Quality Index (PSQI)), and quality of life (World Health Organization Quality of Life-BREF (WHOQOL-BREF)).

Results: After 12 weeks, both groups exhibited significant reductions in HAMA, HAMD, cough, sputum production, chest pain, shortness of breath, mMRC, SGRQ, and PSQI scores, with the study group showing more pronounced decreases (all P < 0.05). FEV1, FVC, PEF, 6MWT distance, and WHOQOL-BREF scores increased significantly in both groups, with greater improvements in the study group (all P < 0.05). IL-8, CEA, and CYFRA21-1 levels decreased significantly in both groups, with IL-8 levels lower in the study group (all P < 0.05); however, no significant differences were observed in CEA or CYFRA21-1 between groups post-intervention (both P > 0.05).

Conclusion: Graded exercise rehabilitation based on pulmonary function classification effectively enhances pulmonary function, relieves symptoms, improves sleep quality, and supports recovery in elderly patients post-lung cancer surgery.