Exercise Capacity, Muscle Strength, Dyspnea, Physical Activity, and Quality of Life in Preoperative Patients with Lung Cancer

Background: To detect the extent to which physical impairments are observed in patients with lung cancer awaiting lung surgery, exercise capacity, muscle strength, physical activity, dyspnea, and quality of life (QOL) were objectively compared between the patients and healthy individuals in current study.

Methods: Patients with lung cancer (n = 26) and healthy individuals (n = 21) were included. Exercise capacity, respiratory (maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP)) and quadriceps femoris muscle strength, physical activity, dyspnea and QOL were evaluated using 6-min walk test (6-MWT), a mouth pressure device, a hand-held dynamometer, a metabolic holter device, Modified Medical Research Council dyspnea scale and European Organization for Research and Treatment of Cancer QOL Questionnaire C30 version 3.0, respectively.

Results: The 6-MWT distance (mean difference: 78.97 m), percentages of predicted MIP and MEP values, physical activity parameters (energy expenditures, physical activity duration, average metabolic equivalent and number of steps) and QOL subscales scores (functional, social function and global health status) were significantly lower in the patients than healthy individuals (p < 0.05). Dyspnea perception and other QOL subscales scores (symptom and fatigue) were significantly higher in patients than healthy individuals (p < 0.05). No significant difference was prevalent in quadriceps femoris muscle strength (p > 0.05). Sixteen (66.7%) patients were sedentary.

Discussion: Severe reductions in exercise capacity, respiratory muscle strength, and physical activity level, poorer QOL and evident dyspnea exist in preoperative patients with lung cancer. Therefore, patients should be included in early protective rehabilitation program including aerobic exercise, respiratory muscle training and physical activity counseling before lung surgery.