肺癌手术前在家远程引导高强度运动康复的评估（PREPACHIR研究）

IF 4.5 2区医学 Q1 ONCOLOGY

Lung Cancer Pub Date : 2025-03-07 DOI:10.1016/j.lungcan.2025.108480

Florent Vinas , Hélène Goussault , Laurent Boyer , Gaëlle Rousseau Bussac , Laurence Jabot , Quentin Gibiot , Valentine Bonnefoy , Marc Antoine Brochard , Seydou Goro , Camille Jung , Isabelle Monnet , Christos Chouaïd , Bernard Maitre , Jean-Bernard Auliac

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引用次数: 0

摘要

术前康复可降低非小细胞肺癌（NSCLC）患者的手术发病率和死亡率。本研究评估了术前康复计划的可行性，包括高强度的运动，在家里，由训练有素的体育教练远程指导。方法本单中心研究纳入诊断为可切除的非小细胞肺癌患者，计划进行节段切除术或肺叶切除术，FEV1 <；80%和/或DLCO <；80%。主要排除标准为新辅助化疗、高强度体力活动禁忌症、对智能手表使用了解不足、不使用智能手机以及认知或精神障碍。该项目结合了每天1小时的在家高强度训练，辅以无人监督的活动建议，以及通过联网手表进行追踪。T.方案疗效评估基于完成整个方案的患者人数、最大摄氧量（VO2 max）的平均增加以及术后并发症的Clavien-Dindo分类。结果纳入期76例符合手术条件的患者中，29例（38%）符合纳入标准，24例（83%）完成了至少7天的培训，平均±标准差为17.8±9次；44%还执行了未排定的补充会议；96%的人使用联网手表。VO2 max由19.3±3.1增加到20.4±3.5 ml/kg/min （p = 0.04）。术后9/25（36%）出现1-3级不良事件，无4/5级不良事件。结论术前在家进行远程引导、高强度训练是可行的，可显著提高VO2 max。需要前瞻性的随机研究来评估与当前护理实践相比的益处。

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Evaluation of teleguided high-intensity exercise rehabilitation at home before lung-cancer surgery (PREPACHIR Study)

Introduction

Preoperative rehabilitation lowers the surgical morbidity–mortality risk of patients with non-small cell lung cancer (NSCLC). This study evaluated the feasibility of a preoperative-rehabilitation program consisting of high-intensity exercises, at home, teleguided by physical trained sports coach.

Methods

This monocenter study included patients diagnosed with resectable NSCLC, scheduled segmentectomy or lobectomy, and FEV1 < 80 % and/or DLCO < 80 %. The main exclusion criteria were neoadjuvant chemotherapy, contraindication for high-intensity physical activity, poor understanding of connected-watch use, without a smartphone and cognitive or psychiatric disorder(s).The program combines 1-hour daily high-intensity training at home, teleguided, associated with non-supervised activity advice, with tracing via an internet-connected watch. T. Program-efficacy evaluation was based on the number of patients completing the entire program, mean increase of the maximum oxygen uptake (VO₂ max) and postoperative complications assessed with the Clavien–Dindo classification.

Results

Among the 76 patients eligible for surgery during the inclusion period, 29 (38 %) satisfied inclusion criteria and 24 (83 %) accomplished at least 7 days of training for a mean ± standard deviation of 17.8 ± 9 sessions; 44 % also executed non-scheduled supplementary sessions; 96 % used the internet-connected watch. VO₂ max increased significantly from 19.3 ± 3.1 to 20.4 ± 3.5 ml/kg/min (p = 0.04). Postoperatively, 9/25 (36 %) experienced a grade 1–3 adverse event, without grade 4/5.

Conclusion

Preoperative rehabilitation with teleguided, high-intensity exercises at home is feasible and significantly increased VO₂ max. Prospective, randomized studies are needed to evaluate the benefit compared to current care practices.

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来源期刊

Lung Cancer 医学-呼吸系统

CiteScore

9.40

自引率

3.80%

发文量

407

审稿时长

25 days

期刊介绍： Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.