No significant difference in pulmonary function was observed between the two groups .
However , 6MWD and VO2 peak were significantly improved after exercise training .
Conclusion Preoperative exercise training may reduce PPCs for lung cancer patients .
Rehabilitation exercise strengthens muscle capacity , but does not improve impaired pulmonary function , which emphasizes the possible mechanism of the protocol design
Objectives This meta- analysis aim ed to demonstrate the impact of preoperative exercise therapy on surgical outcomes in patients with lung cancer and COPD .
Pulmonary function and muscle capacity were investigated to explore their potential links with outcome improvements after exercise .
[Impact and Effect of Preoperative Short-term Pulmonary Rehabilitation Training on  Lung Cancer Patients with Mild to Moderate Chronic Obstructive Pulmonary Disease:  A Randomized Trial].
BACKGROUND Pulmonary rehabilitation ( PR ) is proposed as an effective strategy to decrease surgical morbidity . However , appropriate rehabilitation plan , initiation time , and optimal duration of PR remain unclear . Lung cancer patients with chronic obstructive pulmonary disease ( COPD ) are considered high-risk population for postoperative pulmonary complications ( PPCs ) because of poor lung fitness and cardiopulmonary endurance . This study aims to assess the impact of a one-week , systematic and highly-intensive rehabilitation on surgical lung cancer patients with mild to moderate COPD . METHODS A r and omized controlled trial with 48 subjects was conducted ( 24 patients each for the intervention and groups ) . The intervention group received seven days of systematic , integrated and highly-intensive PR before surgical treatment , including : pharmacotherapy with atomizing terbutaline , pulmicort and infusion of ambroxol ; and physical rehabilitation with respiratory training and endurance training . The control group underwent st and ard preoperative care . RESULTS For the intervention group , the postoperative length of stay was shorter [ ( 6.17±2.91 ) d vs ( 8.08±2.21 ) d ; P=0.013 ] ; likewise for the duration of antibiotics use [ ( 3.61±2.53 ) d vs ( 5.36±3.12 ) d ; P=0.032 ] . No significant difference was found between the groups in total in-hospital cost [ ( 46,455.6±5,080.9 ) ¥ vs ( 45,536.0±4,195.8 ) ¥ , P=0.498 ] , medicine cost [ ( 7,760.3±2,366.0 ) vs ( 6,993.0±2,022.5 ) , P=0.223 ] , and material cost [ ( 21,155.5±10,512.1 ) ¥ vs ( 21,488.8±3,470.6 ) ¥ , P=0.883 ] . In the intervention group , peak expiratory flow [ ( 268.40±123.94 ) L/min vs ( 343.71±123.92 ) L/min ; P<0.001 ] , 6-min walk distance ( 6-MWD ) [ ( 595.42±106.74 ) m vs ( 620.90±99.27 ) m ; P=0.004 ] , and energy consumption [ ( 59.93±10.61 ) kcal vs ( 61.03±10.47 ) kcal ; P=0.004 ] were statistically different after the seven-day exercise , compared with those on the first day . Finally , for the intervention group the incidence of PPCs ( 8.3 % , 2/24 vs 20.8 % , 5/24 , 20.8 % ; P=0.416 ) were lower . CONCLUSIONS The systematic and highly-intensive pulmonary rehabilitation combining abdominal respiration training , respiratory exercise with incentive spirometry , and aerobic exercise could improve the cardiorespiratory endurance of lung cancer patients with mild to moderate COPD . The proposed program may be a practicable preoperative strategy .
No significant difference in pulmonary function was observed between the two groups .
However , 6MWD and VO2 peak were significantly improved after exercise training .
Conclusion Preoperative exercise training may reduce PPCs for lung cancer patients .
Rehabilitation exercise strengthens muscle capacity , but does not improve impaired pulmonary function , which emphasizes the possible mechanism of the protocol design
Objectives This meta- analysis aim ed to demonstrate the impact of preoperative exercise therapy on surgical outcomes in patients with lung cancer and COPD .
Pulmonary function and muscle capacity were investigated to explore their potential links with outcome improvements after exercise .