THE FEASIBILITY OF PREOPERATIVE HIGH- INTENSITY EXERCISE FOR PATIENTS WITH OPERABLE LUNG CANCER: A SERVICE EVALUATION OF AN ESTABLISHED CARDIAC REHABILITATION PROGRAMME

Abstract

Background Patients with operable lung cancer can be elderly, frail and multi-morbid with debilitating symptoms that can increase surgical risk and impair postoperative recovery. A short-term preoperative rehabilitation programme utilising the rapid physiological gains of high-intensity interval training could improve exercise capacity and optimise recovery if tolerated in this patient population. Methods A mixed-methods design was used to evaluate service delivery and review the feasibility of high-intensity interval training (HIIT) in patients with lung cancer awaiting surgical resection within an existing Cardiac Rehabilitation Service. A parameter of 80% heart rate reserve (HRR) was set to determine HIIT attainment. Results The service received 142 referrals for patients with lung cancer over a 12-month period. 100% of patients attended and initial appointment and 73% completed the Rehabilitation programme. 57% of patients achieved 80% HRR and no significant adverse events were reported. Younger age and higher baseline physical activity status were statistically significant for HIIT attainment. Gender, BMI, extent of planned surgical resection, and ASA classification did not appear to be significant in ability to achieve HIIT. Conclusions High uptake and completion rates can be achieved by offering patients with lung cancer access to a preoperative rehabilitation programme. HIIT can be safely considered as a preoperative exercise intervention although may not be achieved in all patient presentations, particularly elderly and those with lower baseline physical activity status. Clinical judgement should be applied in all circumstances.

Keywords

• hiit
• lung cancer
• preoperative rehabilitation
• cardiac rehabilita- tion