Comparison of Postoperative Telerehabilitation and Unsupervised Home-Based Training in Older Adults With Lung Cancer: A Randomized Controlled Trial.

Purpose: To examine the effects of postoperative pulmonary telerehabilitation (PTR) in older adults with lung cancer using a popular mobile instant messenger.

Methods: We conducted a randomized controlled trial in ambulatory patients (n = 64; aged ≥ 65 years) with lung cancer scheduled for video-assisted thoracoscopic surgery. Participants were randomly assigned to intervention (IG) or control (CG) groups. Four weeks after surgery, both groups received a one-time education session on standard home-based pulmonary rehabilitation at the rehabilitation center. The IG underwent a PTR program thrice weekly for 4 weeks using a mobile instant messenger or telephone. Both groups were instructed to maintain their exercise routine (at least 3 times a week) during the 4-week follow-up.

Results: Compared with the CG, the IG showed significant improvements in peak oxygen uptake (VO 2peak ) and percent predicted VO 2peak of 3.3 mL/kg/min (95% CI, 1.9-4.8; P < .001) and 14% (95% CI, 7-21; P < .001), respectively, after PTR. These improvements persisted at the 4-week follow-up (VO 2peak = 3.8 mL/kg/min: 95% CI, 2.1-5.5; P < .001 and percent predicted VO 2peak = 13%: 95% CI, 6-20; P < .001). Compared with preoperative values, postoperative VO 2peak and percent predicted VO 2peak decreased significantly by 3.5 mL/kg/min (95% CI, 2.6-4.3; P < .001) and 15% (95% CI, 11-19; P < .001), respectively.

Conclusions: A 4-week postoperative PTR program improved VO 2peak in older adults with lung cancer. Our findings suggest that PTR may be a feasible therapeutic strategy for lung cancer, even in older adults.