Effects of Telerehabilitation Based on Motion Recognition Technology on Exercise Endurance of Patients With Non–Small Cell Lung Cancer After Surgery: Single-Center, Prospective, Open-Label, Randomized Controlled Trial

Background Non–small cell lung cancer (NSCLC) accounts for approximately 85% of primary pulmonary neoplasms. Complete surgical removal remains the cornerstone of curative therapy, yet it frequently diminishes residual lung function and exercise tolerance. Structured, center-based rehabilitation hastens physiological recovery, but conventional schemes rarely deliver continuous, patient-specific monitoring. Remote, digitally delivered exercise overcomes logistical obstacles; however, the lack of real-time quality assurance curtails effectiveness. Wearable motion capture platforms that provide millimeter-precise kinematic data and instantaneous biomechanical feedback can close this supervisory void by confirming movement accuracy and issuing immediate corrective prompts. Whether this technologically augmented telerehabilitation yields clinically relevant improvements in postoperative exercise capacity after NSCLC resection remains inadequately established. Objective This study aims to find out whether motion capture–enabled telerehabilitation can enhance exercise endurance and functional recovery following NSCLC resection, thereby filling a critical void in postoperative care pathways. Methods We performed a single-center, parallel-arm randomized trial in individuals who had completed curative lung resection for NSCLC and satisfied every enrollment criterion. Following randomization, eligible patients were assigned either to a technology-enhanced telerehabilitation protocol incorporating live motion sensing or to a WeChat-based regimen without that feedback layer. Each program spanned 4 weeks. Assessments—comprising exercise endurance, spirometric variables, health-related quality of life, and daily physical activity—were collected at discharge and repeated 4 weeks after intervention. Results No exercise-related adverse events occurred during the 4-week intervention. Compared with conventional video-guided training, the motion recognition group demonstrated significantly greater improvements in exercise tolerance, pulmonary function, selected functional mobility outcomes, and quality of life. The intervention group achieved a greater increase in 6-minute walk distance (mean difference 32 meters, 95% CI 5.40-58.60; P=.02). Significant between-group differences were also observed in forced vital capacity (mean difference 476.4 mL; P=.02), forced expiratory volume in 1 second (mean difference 346.0 mL; P=.04), FEV1/FVC ratio (mean difference 12.8%; P=.03), and peak expiratory flow (mean difference 70.8 L/minute; P=.002). For functional mobility, the intervention group showed superior improvement in the Timed Up and Go test (mean difference −1.63 seconds; P=.04), whereas no significant between-group differences were found in other mobility measures. Quality of life outcomes favored the motion recognition group, with greater improvements in physical well-being, functional well-being, additional concerns–lung subscale, and total Functional Assessment of Cancer Therapy–Lung score (mean difference 13.00; P<.001). Program adherence was higher in the intervention group (72% vs 40%; P=.02). Conclusions Four-week motion capture–guided telerehabilitation yielded clinically meaningful gains in aerobic endurance, spirometric indices, ambulatory capacity, and global health–related quality of life for patients recovering from NSCLC surgery, underscoring its usefulness as a safe and effective remote care strategy. Trial Registration Chinese Clinical Trial Registry ChiCTR2500113139; https://www.chictr.org.cn/showprojEN.html?proj=270991