Does preoperative exercise training prevent functional decline after video-assisted thoracic surgery?

Abstract

Introduction: Prehabilitation of surgical patients is gaining popularity specially among those who exhibit poor baseline status. In this study, we aimed to evaluate whether prehabilitation of patients undergoing lung resection surgery by Video-assisted thoracic surgery (VATS) prevents the functional decline observed after surgery and enhances postoperative recovery.

Material and Methods: 40 patients scheduled for lung resection surgery were initially randomized in two groups. Patients in the Rehabilitation Group (RG) received a preoperative exercise-based intervention consisted of 3 - 5 sessions per week of interval endurance training, resistance training with elastic bands and breathing exercises. Patients in the Control Group (CG) received standard care (no prehabilitation). Exercise capacity (endurance time), functional capacity (6-minute walk test), muscle strength (Senior Fitness Test) and health-related quality of life (SF-36) were measured at baseline (T0) and three weeks (T1) and three months (T2) post-surgery.

Results: 22 patients completed the study and were analysed. There were no statistically significant differences between groups at T1 in any of the main outcomes. However, at T2, patients in the RG had improved their endurance time and lower muscle strength comparing to baseline which led to statistically significant differences with the CG in the endurance time and both upper and lower muscle strength (p<.05). There were also significant differences in the physical component summary and bodily pain of the SF-36 (p<.01).

Conclusions: Preoperative exercise training seems to prevent the functional decline observed after VATS and hastens postoperative recovery.