| 제목 |
Feasibility of Pulmonary Rehabilitation Program for Lung Cancer Patient Undergoing Radiation Therapy |
| 소속 |
Asan Medical Center, University of Ulsan College of Medicine, Department of Rehabilitation Medicine1, Asan Medical Center, University of Ulsan College of Medicine, Department of Radiation Oncology2, Asan Medical Center, University of Ulsan College of Medicine, Department of Pulmonary and Critical Care Medicine3 |
| 저자 |
Hyejoon Ahn1*, Seung Hak Lee1†, Jae Yong Jeon1, Su Ssan Kim2, Si Yeol Song2, Won Kim1, Sei Won Lee3, A Hyun Kim1 |
OBJECTIVE
This study aims to confirm the feasibility of an outpatient-based pulmonary rehabilitation program (PR) in lung cancer patients receiving radiation therapy.
METHODS
Retrospective chart review was conducted for patients with lung cancer who had undergone radiation therapy between July 2019 and December 2019. Patients received outpatient-based PR, a total of eight sessions two times a week, consisting of 60 minutes per session. The outpatient-based PR program was four consecutive weeks in duration, with two sessions per week. A 60-minute exercise session was conducted under the supervision and guidance of a physical therapist. A session was performed in the following order: warm-up (10 minutes); strengthening exercise (20 minutes); aerobic exercise (20 minutes), and cool-down (10 minutes). Strengthening exercise includes squats, bridge exercise, bird dog exercise and leg lowering drill at an intensity of 13-15 points of RPE (Rating of perceived exertion). And aerobic exercise using a fixed cycle was used at an intensity in the range of 65-85% of maximum heart rate, which was based on age, with 13-15 point intensity according to the Borg scale. During each session, physical therapist monitored side effect including fatigue, breathing difficulty, muscle pain, etc.
Feasibility was assessed based on completion of the pulmonary rehabilitation program. Functional evaluations using a 6-minute walk test and a grip strength test were conducted before and after PR. Patients’ quality of life were assessed by EORTC-QLQ-C30 Questionnaire before and after PR (Figure 1-A).
RESULTS
Between July 2019 and December 2019, 40 patients who underwent PR program for lung cancer patient receiving radiation therapy were started and 29 patients completed PR program (21 men, 8 women; median age 65.8 years). 19 patients were smokers and 26 patients were diagnosed with NSCLC (Table 1).
Among the 40 patients, 29 (72.5%) successfully completed the program (Figure 1-B). No adverse events related to PR were reported. Mean distance of 6-minute walk test significantly increased from 423.0m to 454.5m. Grip strength test in dominant hand improved after PR program, but was not statistically significant. Overall satisfaction was 5.7 ± 1.1 and self-reported helpfulness of PR program for undergoing radiation therapy (6.1 ± 0.9) items had the highest scores in all participants. Social functioning score in EORTC-QLQ-30 showed improvement with statistically significance (Table 2).
CONCLUSION
This study showed that a four-week outpatient-based PR program for lung cancer patients undergoing outpatient-based radiation therapy is feasible without serious adverse effects. And this program might improve patients’ physical function and quality of life.
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Figure 1. A. Process of outpatient-based pulmonary rehabilation program B. Completion rate of pulmonary rehabilitation program
Table 1. Bas eline characteristics of pa rticipants and functional outcomes before and after pulmonary rehabilitation program.
Table2. Results of functional outcomes and EORTC QLQ C30 before and after PR program in lung cancer patients receiving radiation therapy and usability assessment results of PR program by a self report questionnaire using a 7 point Likert scale.
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