Randomised controlled trial of home-based exercise and self-management following lung cancer surgery

<bold>Aim:</bold> To evaluate a home-based exercise and self-management program for patients following lung cancer surgery. Method: Assessor-blinded, multisite, randomised control trial (concealed allocation) in Australia. Patients scheduled for lung resection were randomly allocated to usual care or a 3-month post-operative program (home-based exercise and weekly physiotherapist-led telephone consultations). Primary outcome was physical function (EORTC QLQc30 questionnaire) at 3-months post-op. Secondary outcomes were completed at 3, 6 (objective and patient-reported) and 12 months (patient-reported). Constrained longitudinal data analysis was used to examine differences in outcomes between groups. Trial registration ACTRN12617001283369. <bold>Results:</bold> Of the 116 participants [mean(SD) age 66(10) years; 59% female], 102 (88%) participants were retained at 3-months and 95 (82%) at 6 and 12-months. There were no between group differences in physical function at 3-months (mean difference 1.0, 95%CI -6.0 to 8.0), or 6- or 12- month follow-up. At 3-months the program resulted in greater improvements in exercise capacity (6-min walk distance 39.7 m, 6.8 to 72.6), global quality of life (7.1, 0.4 to 13.8) and exercise self-efficacy (16.0, 7.0 to 24.9). Program improvements were maintained at 6-months in 6-min walk distance (50.9 m, 6.7 to 95.1) and exercise self-efficacy. <bold>Conclusion:</bold> A post-operative home exercise program supported remotely by physiotherapists improved patients’ exercise capacity and exercise self-efficacy but not the primary outcome of self-rated physical function at 3-months. Improvements in 6-min walk distance were clinically significant and retained beyond conclusion of the program.