Early lung function after surgery may be improved in patients with non-small cell lung cancer (NSCLC) with physical manipulation pulmonary rehabilitation (PMPR), according to results of a randomized, controlled trial, published in Thoracic Cancer.

After undergoing lung tissue resection for NSCLC, the majority of patients experience long-term decreased respiratory function that affects quality of life. To assess whether PMPR could improve function, researchers recruited 86 patients with NSCLC who had undergone lobectomy at the Beijing Hospital in China between April and June 2021. Patients were randomly assigned to receive conventional pulmonary rehabilitation (CVPR) for 28 days (42 patients) or PMPR for 14 days plus CVPR (44 patients). PMPR comprised daily physical intercostal muscle and rib mobilization, thoracic induction, and induced abdominal breathing.

The patient population comprised 56.9% were men, mean age 61.7±9.7 years, 48.8% underwent a lobectomy plus partial resection, and 55.8% had squamous cell carcinoma.

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Lung function was decreased in all patients after surgery.

At 21 days, the PMPR recipients had higher peak flow velocity during peak expiratory flow (mean, 316 vs 272 l/min; P =.043),forced expiratory volume in 1 second (mean, 2.1 vs 1.9 L; P <.001), and the ratio between the 2 measures (74% vs 69%; P =.009). No group differences were observed for forced vital capacity (mean, 2.9 vs 2.8 L; P >.05) or the 6 minute walk test (mean, 402 vs 397 m; P >.05).

PMPR recipients returned to baseline forced expiratory volume in 1 second values at day 28 but those in the control group did not.

This study was limited by not including overall health assessments, the small sample size, and short study duration. Additional study is needed.

The researchers concluded that PMPR may improve lung function following surgical treatment of NSCLC.


Zhou T, Sun C. Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy.Thorac Cancer. Published online December 9, 2021. doi:10.1111/1759-7714.14225