Structured Pulmonary Physiotherapy After Lung Cancer Surgery by Age Group

Bezmialem Vakif University60 enrolled

Overview

This prospective, single-arm interventional study aims to evaluate the effectiveness of a structured postoperative pulmonary physiotherapy program delivered by the research team in patients undergoing lung cancer surgery. The intervention consists of chest physiotherapy, bronchial hygiene techniques, early mobilization, and postural exercises applied under physiotherapist supervision during the postoperative hospital stay. The primary outcome is length of hospital stay. Secondary outcomes include blood pressure, heart rate, oxygen saturation, fatigue, and dyspnea levels. Clinical outcomes will be analyzed according to age groups (45-59 years and 60-90 years) to determine potential age-related differences in response to the intervention.

This interventional study aims to evaluate the effectiveness of a structured pulmonary physiotherapy program applied after lung cancer surgery across different age groups. Patients aged 45 years and older undergoing lung resection will be included and categorized into two age groups (45-60 years and ≥60 years) for subgroup analysis. The structured postoperative pulmonary physiotherapy program is initiated in the early postoperative period and continued until hospital discharge. The program includes chest physiotherapy techniques, early mobilization, postural exercises, and incentive spirometry training. The intervention is delivered once daily under physiotherapist supervision, and participants are instructed to continue prescribed breathing, incentive spirometry, and mobilization exercises independently during the afternoon and evening sessions. The primary outcome measure is length of hospital stay. Secondary outcomes include postoperative pain assessed by Visual Analog Scale (VAS), dyspnea and fatigue assessed by Borg scale, oxygen saturation, hemodynamic parameters, and inflammatory and biochemical markers including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), albumin, prealbumin, creatine kinase (CK), and lactate dehydrogenase (LDH). Clinical, physiological, and biochemical outcomes are assessed from the early postoperative period until hospital discharge. The study further aims to explore potential differences in treatment response between predefined age groups. No randomization or control group is included, as all participants receive the same structured physiotherapy intervention.

Study Type

INTERVENTIONAL

Allocation

Interventions

Structured Postoperative Pulmonary Physiotherapy ProgramBEHAVIORAL

The structured postoperative pulmonary physiotherapy program is delivered by the research team during the hospital stay following lung cancer surgery. The intervention is applied according to a standardized protocol and includes supervised chest physiotherapy techniques (deep breathing exercises, thoracic expansion exercises, airway clearance techniques, and incentive spirometry), early mobilization (progressive sitting, standing, and ambulation), and postural exercises. The program is administered once daily under physiotherapist supervision. In addition, participants are instructed to continue the prescribed breathing, incentive spirometry, and mobilization exercises independently during the afternoon and evening sessions. The intervention is initiated in the early postoperative period and continues until hospital discharge.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients aged 45 to 90 years * Undergoing lung cancer surgery (lobectomy, segmentectomy, or pneumonectomy) * Medically stable in the early postoperative period * Able to participate in a structured pulmonary physiotherapy program * Provided written informed consent Exclusion Criteria: * Hemodynamic instability preventing mobilization * Severe cognitive impairment limiting cooperation * Neurological or orthopedic conditions restricting mobilization * Requirement for prolonged mechanical ventilation * Presence of another active malignancy * Any medical contraindication to physiotherapy as determined by the attending physician

Outcomes

Primary Outcomes

Length of Hospital Stay

Length of hospital stay is defined as the number of days from postoperative admission to the ward until hospital discharge following lung cancer surgery.

Time frame: Postoperative period, from ward admission after surgery until hospital discharge (maximum 30 postoperative days)

C-reactive protein (CRP)

Serum CRP levels (mg/L) will be measured to evaluate postoperative systemic inflammatory response.