Maja S. Sommer , Maja E.B Staerkind, Jan Christensen, Jette Vibe-Petersen, Klaus R. Larsen, Jesper Holst Pedersen, Henning Langberg
Copenhagen Centre for Cancer and Health, Dk-2200 Copenhagen, Denmark. E-mail: mss@kraeftcenter-kbh.dk
DOI: 10.2340/16501977-2292

Objective: To review the evidence concerning the effects of postoperative exercise interventions on exercise capacity and health-related quality of life following resection for non-small cell lung cancer, and to review whether different initiation times of exercise produce different effects on exercise capacity.
Data sources: Comprehensive literature search of MEDLINE, Embase, CENTRAL, CINAHL and PEDro.
Study selection: Randomized controlled trials examining the effects of exercise interventions were eligible for inclusion.
Data extraction: Postoperative outcome measurements were extracted and the quality of evidence was graded using Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group.
Data synthesis: Four randomized controlled trials were identified involving 262 participants. Short-term follow-up (12–20 weeks) showed significantly higher exercise capacity and physical component of health-related quality of life in the intervention group (standardized mean difference (SMD) 0. 48; 95% confidence interval (CI) 0. 04–0. 93) compared with the control group (SMD 0. 50; 95% CI 0. 19–0. 82). There was no difference between the effect of late- and early-initiated exercise intervention.
Conclusion: Exercise has a small-to-moderate effect at short-term follow-up on exercise capacity and the physical component of health-related quality of life in patients operated for lung cancer. The long-term effects of exercise capacity are unknown. Early-initiated exercise programmes (2 weeks post-operation) did not show an effect on exercise capacity. These findings should be interpreted with caution.

Patients who undergo surgery for lung cancer experience a drop in physical function due to loss of physical capacity as well as a reduced quality of life. We systematically reviewed the literature to identify studies evaluating the effect of exercise initiated after surgery. This review mainly addresses studies where the basis evaluation is collected after the lung cancer surgery. The literature review investigated whether the onset of exercise after surgery had an impact on the clinical outcome of the rehabilitation on physical capacity in patients with operable lung cancer. We found that active rehabilitation after surgery may improve both physical capacity and quality of life in patients undergoing surgery for lung cancer. The literature review also revealed that very little research encompass knowledge about the influence of when exercise is initiated after lung cancer surgery.

Appendix S1-5