Effect of multimodal prehabilitation with wearable device monitoring in lung cancer patients after neoadjuvant therapy: a randomized controlled trial

Neoadjuvant therapy for lung cancer often impairs preoperative function. Although multimodal prehabilitation shows promise, its efficacy with wearable device monitoring remains unproven. This study aimed to evaluate the effects of multimodal prehabilitation with wearable device monitoring on perioperative function, recovery, and quality of life in lung cancer patients post-neoadjuvant therapy. A single-blinded, parallel-group, randomized controlled trial was conducted. Fifty-two patients with lung cancer who had completed neoadjuvant therapy and were scheduled for lung resection were randomized to 3–4 weeks of prehabilitation (integrating exercise, nutrition, and psychological support with wearable device monitoring) or standard care. The primary outcome was the 6-minute walk distance (6MWD). The secondary outcomes included quality of life (assessed by the 30-item European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30)), frailty (assessed by the frailty scale), depression and anxiety (assessed by the Hospital Anxiety and Depression Scale (HADS)), and postoperative recovery (assessed by the 15-item Quality of Recovery Scale (QoR-15)). Compared with the control group, the prehabilitation group demonstrated significantly better outcomes in terms of the perioperative 6MWD (F group =3.411, P < 0.001). Exploratory analysis showed that the prehabilitation group had potential improvements in postoperative QoR-15 scores (F group = 52.334, P < 0.001), key quality-of-life dimensions (global health status, physical functioning, role functioning, emotional functioning, cognitive functioning, and fatigue, all corrected P < 0.0025), frailty levels (χ²=6.980, P = 0.030), and HADS depression scores (F group =27.228, P < 0.001). No significant differences in HADS anxiety scores, pulmonary function parameters, surgery time, extubation time, postoperative length of stay, cost, or incidence of complications were detected between the groups. Multimodal prehabilitation with wearable device monitoring demonstrates beneficial effects on functional capacity, postoperative recovery, and quality of life in lung cancer patients after neoadjuvant therapy. This study was retrospectively registered at the Chinese Clinical Trial Registry. Registration Date April 29, 2024. Registration Number ChiCTR2400083619.