The paradigm of pre-operative exercise as a neoadjuvant therapy to reduce morbidity is increasingly promoted within general surgery and surgical oncology. Patients with lung cancer participating in pre-operative exercise have better aerobic capacity and pulmonary function and shorter hospital length-of-stay after surgery. Additionally, pre-operative exercise may increase the likelihood of resuming exercise post-surgery, thereby accelerating the pace of rehabilitation and recovery. In order to translate the research findings into sustainable clinical practice, clinician-scientists need to develop pragmatic and effective home-based exercise protocols. Wearable fitness devices offer a way to approximate the supervision that occurs in exercise research. Before the investigators can develop an intervention in which patients receive tailored support similar to what occurs with supervised exercise, they need to pilot test the monitoring aspect of the wearable fitness device in conjunction with the pre-operative exercise program. The investigators propose a mixed methods, 16 single arm feasibility study of an unsupervised, pre-operative exercise prescription (uPEP) augmented by a wearable fitness device. The proposed study of 30 patients scheduled for lung cancer surgery will identify the strengths, weaknesses, and utility of this approach.
The investigators propose a parallel mixed methods, 16 single arm, pre-post study with 30 participants scheduled for lung cancer surgery. At time of enrollment (at least 3 weeks before their scheduled surgery), participants will complete baseline assessments, receive the uPEP exercise prescription, and be oriented to the wearable fitness device. A research assistant will call the participant to conduct an audiotaped semi-structured interview regarding the acceptability of the electronically-monitored uPEP within 7- 14 days of enrollment. The study team will complete follow-up assessments on the day of surgery, two weeks after surgery, and four months after surgery. Data will also be collected from chart review and the wearable fitness device throughout the study.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
single arm feasibility study of an unsupervised, pre-operative exercise prescription (uPEP) augmented by a wearable fitness device.
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, United States
Adherence to exercise:
number of completed pre-operative exercise sessions divided by number of prescribed sessions, according to exercise log
Time frame: Time 3, day of surgery
Feasibility of recruitment:
number of patients enrolled divided by number of patients eligible
Time frame: Time 5, 16 weeks post-surgery
Acceptance of technology
number of hours the fitness tracker was worn in pre-operative period
Time frame: Time 3, day of surgery
Participant perception of exercise program
semi-structured interview regarding perceptions of the exercise program
Time frame: Time 2, 3-5 days before surgery
Participant perception of fitness tracker
semi-structured interview regarding perceptions of the fitness tracker
Time frame: Time 2, 3-5 days before surgery
Subjective minutes spent in exercise
Number of minutes spent in exercise according to exercise log
Time frame: Time 3, day of surgery
Objective minutes spent in exercise:
Number of minutes spent in exercise according to fitness tracker
Time frame: Time 3, day of surgery
Aerobic capacity:
Six minute walk test
Time frame: Time 3, day of surgery
Pulmonary function:
Diffusion of lungs for carbon monoxide test
Time frame: Time 2, 3-5 days before surgery
Subjective physical function:
PROMIS (Patient-Reported Outcomes Measurement Information System) physical function scale
Time frame: Time 2, 3-5 days before surgery
Objective physical function:
Grip strength per dynamometer
Time frame: Time 3, day of surgery
Length of stay in hospital:
Number of days from surgery to discharge home
Time frame: Time 4, 2 weeks post-surgery
Feasibility of Retention
Number of patients completing all study assessments divided by the number enrolled
Time frame: 16 weeks post-surgery
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