Photo Credit: Monkeybusinessimages

A perioperative exercise intervention using wearable devices improved physical activity and dyspnea 6 months after lung cancer surgery.

A wearable device intervention may improve postoperative recovery, including physical activity and patient-reported dyspnea, in patients with non-small cell lung cancer, according to findings published in JAMA Network Open.

“Emerging evidence suggests that wearable devices are feasible for monitoring physical activity among patients with lung cancer,” researchers wrote. “However, the association between wearable devices and improvement in patient recovery after surgery remains underexplored.”

Investigators conducted a non-randomized clinical trial with a historical control from October 18, 2018, to May 24, 2019, to assess the impact of a wearable device intervention on the recovery process, specifically physical activity following lung cancer surgery, and the impact of wearable devices on cardiopulmonary function and HRQOL.

The study included 194 patients, including 74 patients with suspected or confirmed NSCLC scheduled for curative surgery more extensive than lobectomy. The control group included 120 patients who were not utilizing the wearable intervention.

The intervention cohort received a patient-centered exercise regimen monitored via a wearable device at home in three stages: preoperative (from diagnosis to surgery), immediate (from discharge to 2 months post-surgery), and later postoperative (from 2 to 6 months post-surgery).

Additionally, an exercise physiologist employed web-based data from the wearable device to advise the patient via weekly or biweekly calls, establishing goals to progressively increase daily steps and moderate-to-vigorous physical activity.

Patients in the control group obtained the usual care, which included inspiratory exercises using an incentive spirometer and walking exercises.

Personalizing Exercise Programs After Surgery

Two weeks after surgery, the number of daily steps, moderate-to-vigorous physical activity, and six-minute walking distance initially decreased but continued to increase afterward. Compared with the intervention group, at two weeks post-op, the control group had a more significant decrease in daily steps from baseline (−4,877 vs −1,753 steps).

From baseline to 6 months after surgery, the intervention group augmented their daily steps by 2,220, while the control group did not return to their baseline number of steps. Additionally, compared to the control group, the intervention group increased their daily steps, had greater vigorous physical activity, had better patient-reported physical function, less dyspnea, less pain 2 weeks after surgery, and less dyspnea 6 months after surgery.

“In this non-randomized clinical trial, integration of perioperative exercise interventions using wearable devices improved physical activity (especially [moderate-to-vigorous physical activity]) and dyspnea at 6 months after lung cancer surgery compared with usual care,” investigators wrote.

The researchers added, “This finding supports the development of personalized exercise regimens with wearable devices, advocating for their inclusion in comprehensive perioperative rehabilitation programs.”