Prescrição de exercícios de precisão para pacientes com câncer de pulmão submetidos a cirurgia: o estudo PEP (PEP)

Experimental: Programa de exercícios personalizados

Comportamental: Programa de exercícios personalizados

A intervenção PEP envolve uma combinação de exercícios em casa, bem como exercícios no paciente. Os modos de exercício incluirão transferência básica e mobilidade calistênica, exercícios aeróbicos e de resistência e serão realizados em várias posturas (supino, sentado, em pé e andando) com desafios variáveis ​​(caminhada nivelada, flexão, inclinações, degraus e agachamento).

Para pacientes randomizados para o Grupo de Intervenção (Grupo 1), a intervenção PEP será personalizada, implementada e modificada (com base no estágio de mobilidade AM-PAC do paciente) por um fisioterapeuta licenciado em atendimento presencial, virtual ou por telefone reuniões (~30-40 minutos). Um manual de educação de exercícios, desenvolvido especificamente para este estudo, será usado pelo fisioterapeuta para educar os pacientes sobre todos os aspectos de iniciar e manter a intervenção de exercícios.

Sem intervenção: Padrão de Cuidados - Nenhum Exercício

Mobility Performance - Six Minute Walk (6MW) Distance

Six Minute Walk (6MW) distance is the distance patients can walk indoors on a 25-meter level, smooth-surfaced track over the course of 6 minutes. This outcome will report the mean 6MW distance at hospital discharge (up to 38 days after the initiation of the study intervention), at the 2-Month Post Surgery Visit (up to 5 months from the initiation of the study intervention), and at the 6-Month Post Surgery Visit (up to 9 months from the initiation of the study intervention).

Evaluate the Change Short Physical Performance Battery (SPPB) Score

This outcome will report the results from the Short Physical Performance Battery (SPPB).

This secondary outcome measure is associated with the evaluation of improvement in physical performance is the result of the short physical performance battery test. The SPPB score (ranging from 0 to 12) will be obtained for each patient at the time points described above. A score of 0 indicates the worst performance, and a score of 12 indicates the best performance.

This outcome will report median SPPB scores at hospital discharge (up to 38 days after the initiation of the study intervention), at the 2-Month Post Surgery Visit (up to 5 months from the initiation of the study intervention), and at the 6-Month Post Surgery Visit (up to 9 months from the initiation of the study intervention).

FACT-L (Functional Assessment of Cancer Therapy-Lung) Questionnaire

The FACT-L (Functional Assessment of Cancer Therapy-Lung) questionnaire assesses health-related quality of life (QOL). Total scores range from 0-136, with lower scores representing worse QOL and higher scores representing better QOL.

This outcome measure will report mean FACT-L total scores at Hospital Discharge (up to 38 days after the initiation of the study therapy), 2-Month Post Surgery Visit (up to 5 months after the initiation of the study therapy), and 6-Month Post Surgery Visit (up to 9 months after the initiation of the study therapy).

Fatigue Subscale (FS)

This outcome will report the results of the Fatigue Subscale (FS) from the FACIT-F (Chronic Illness Fatigue Scale) questionnaire. The FACIT-F is a self-reported evaluation of fatigue in cancer patients. This questionnaire has patients rank statements regarding physical well-being, social/family well-being, emotional well-being, functional well-being, and additional concerns from 0 Not at All to 4 Very Much.

This outcome will report the FS score from the FACIT-F. The FS has a minimum of 0 and a maximum of 52; the higher the score the better the Quality of Life (QOL). The FS Score is calculated from 13 survey items. Individual items that were "reverse items" (meaning a high value indicates poor QOL) were subtracted from 4. Then all "reverse items" and normal items were added together to calculate the FS score.

This assessment was scored according to the FACIT-F Scoring Guidelines (Version 4).

BREQ-3 (Behavioral Regulation in Exercise Questionnaire 3) Questionnaire

This outcome will report the results of the BREQ-3. The questionnaire has 24 items, each item ranging from 0 "Not True for Me" to 4 "Very True for Me".

This questionnaire will report 6 sub-scores, Amotivation, External Regulation, Introjected Regulation, Identified Regulation, Integrated Regulation, Intrinsic Regulation.

Each sub score is a the average of 4 items, ranging from 0-4 with higher values indicating higher motivation.