Evaluating patients’ walking capacity during hospitalization for lung cancer resection

OBJECTIVES: The goal of this study was to describe non-supervised daily physical activity in patients during the period immediately following anatomical lung resection. METHODS: The study was an observational study on 50 consecutive patients (33 men) admitted for anatomical lung resection over a 4-month period. All cases were approached using a minimally invasive technique. Patients were instructed by nursing and physiotherapy staff and asked to wear a portable pedometer (Omron HJ-720 T-E2) from admission until hospital discharge, excluding the day of the operation and the first hours in the recovery room. The variables collected included sex, age, body mass index, type of lung resection, cardiopulmonary postoperative complications, percentage forced expiratory volume in 1 s, percentage single-breath carbon monoxide diffusing capacity, predicted postoperative forced expiratory volume in 1 s calculated according to functional segments removed at surgery, predicted postoperative single-breath carbon monoxide diffusing capacity calculated according to functional segments removed at surgery, total steps, aerobic steps and daily total strolled distance in metres. Comparison of activity was analysed using the paired t-test for individual data evolution and the unpaired t-test for patients showing complications or not. Body mass index and exercise capacity were analysed using the Spearman correlation analysis. RESULTS: A total of 34 patients underwent lobectomy or bilobectomy. All patients could walk on the first postoperative day. The average walked distance on the first and fourth postoperative days was 6100 m and 7400 m, respectively. Compared with the preoperative day, patients walked significantly fewer total steps on Day 1 and Day 2 (Day 1, P = 0.0001; Day 2, P = 0.049). The rate of aerobic to total daily steps was comparable after the second postoperative day. Patients having any postoperative cardiopulmonary complication showed a significantly inferior walking capacity (P < 0.001), both preoperatively and postoperatively, than their peers without complications. CONCLUSIONS: After anatomical lung resection, patients could perform a relevant amount of physical activity. These data could be useful for designing physical recovery programmes to be implemented postoperatively.