Rehabilitation in Advanced Lung Cancer Patients During Chemotherapy


Variable

Rehabilitation group

Control group

Before PR

After PR

p-value

Before observation

After observation

p-value

MRC

1.3 ± 1.1

0.6 ± 0.5

0.047

1.4 ± 0.9

1.8 ± 1.3

0.313

OCD

2.0 ± 0.8

2.3 ± 0.9

0.375

1.6 ± 1.4

1.6 ± 1.3

0.999

FI

3.1 ± 0.9

3.2 ± 0.8

0.844

3.0 ± 1.1

3.0 ± 1.3

0.938

MT

3.3 ± 0.7

3.3 ± 0.8

0.999

3.5 ± 0.8

3.4 ± 1.1

0.562

ME

3.2 ± 0.9

3.6 ± 0.8

0.313

3.1 ± 0.8

3.3 ± 1.0

0.813

BDI

9.6 ± 2.3

10.0 ± 1.5

0.844

9.6 ± 2.1

9.6 ± 3.0

0.844

6MWT (m)

527.3 ± 107.4

563.9 ± 64.6

0.252

502.8 ± 105.0

509.4 ± 134.3

0.816

FEV1 (%)

66.9 ± 13.2

78.4 ± 17.7

0.016

67.5 ± 26.1

70.3 ± 26.6

0.844

FVC (%)

83.0 ± 16.3

89.6 ± 22.1

0.219

79.8 ± 23.1

81.8 ± 22.3

0.844


Data are means ± SD

PR pulmonary rehabilitation, MRC Medical RESEARCH COUNCIL questionnaire, OCD oxygen cost diagram, FI Functional Impairment, MT Magnitude of Task, ME Magnitude of Effort, BDI Basic dyspnea index (FI + MT + ME), 6MWT six-minute-walk test, FEV1 forced expiratory volume in 1 s, FVC forced vital capacity



In the rehabilitation group, there was a statistically significant improvement in FEV1 (66.9 ± 13.2 vs. 78.4 ± 17.7; p = 0.016) after completion of rehabilitation. In contrast, no significant differences were observed in FEV1 in the control group which did not perform physical rehabilitation (67.5 ± 26.1 vs. 70.3 ± 26.6; p = 0.844). The mean result of FVC showed no statistical increase in either group (Table 1).

MRC was the only dyspnea scale where there was observed a significant (1.3 ± 1.1 vs. 0.6 ± 0.5; p < 0.05) decrease in the rating of dyspnea after completion of rehabilitation. Conversely, in the control patients without physical rehabilitation a tendency for an increase in dyspnea was noticed (1.4 ± 0.9 vs. 1.8 ± 1.3; p > 0.05). The mean values of OCD were 2.0 ± 0.8 vs. 2.3 ± 0.9 and those of BDI were 9.6 ± 2.3 vs. 10.0 ± 1.5, before and after physical rehabilitation, respectively. These findings also pointed to a decrease in the sensation of dyspnea after physical rehabilitation, which, however, could not be statistically confirmed in the small sample of patients. In the control group, the mean values of OCD (1.6 ± 1.4 vs. 1.6 ± 1.3) and BDI (9.6 ± 2.1 vs. 9.6 ± 3.0) remained unchanged after the 8 weeks observation.

There also was a somehow greater increase in the Magnitude of Effort domain (3.2 ± 0.9 vs. 3.6 ± 0.8) in the rehabilitation group than that in the control group (3.1 ± 0.8 vs. 3.3 ± 1.0). A similar tendency was observed in Functional Impairment (3.1 ± 0.9 vs. 3.2 ± 0.8 in the rehabilitation group) and (3.0 ± 1.1 vs. 3.0 ± 1.3 in the control group). Concerning the Magnitude of Task, there was no change in the rehabilitation group, (3.3 ± 0.7 vs. 3.3 ± 0.8), but a tendency for increase in the control group (3.5 ± 0.8 vs. 3.4 ± 1.1) after the period of 8 weeks (Table 1).

The SF-36 general quality of life questionnaire showed a marked reduction in the perception of quality of life in all domains in both rehabilitation and control groups, with no statistically significant improvement after the completion of the 8-week long study protocol in either group (Table 2). The mean result of any domain hardly exceeded 50 points, and in about half of the domains it was in a range of 30 odd points. Despite the lack of appreciable improvement in the rehabilitation group, there was an upward trend in 8 domains (BP, VT, GH, RP, RE, SF, MH, and MCS) and a decrease in 2 domains (PF and PCS) there after physical rehabilitation. For comparison, the upward trend was observed in 2 domains (BP and GH) and a decrease in 8 domains (VT, RP, RE, SF, MH, MCS, PF, and PCS) in the control group that did not have rehabilitation.


Table 2
Rating of quality of life in the rehabilitation group before and after pulmonary rehabilitation and in the control group without physical rehabilitation




























Variable

Rehabilitation group

Control group

Before PR

After PR

p-value

Before observation

After observation

p-value

PF

47.7 ± 17.7

45.3 ± 7.5

0.432
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Jul 2, 2016 | Posted by in RESPIRATORY | Comments Off on Rehabilitation in Advanced Lung Cancer Patients During Chemotherapy

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