PMID- 33930327
OWN - NLM
STAT- MEDLINE
DCOM- 20211213
LR  - 20220808
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Print)
IS  - 0003-9993 (Linking)
VI  - 102
IP  - 12
DP  - 2021 Dec
TI  - Effects of Preoperative Breathing Exercise on Postoperative Outcomes for Patients 
      With Lung Cancer Undergoing Curative Intent Lung Resection: A Meta-analysis.
PG  - 2416-2427.e4
LID - S0003-9993(21)00319-1 [pii]
LID - 10.1016/j.apmr.2021.03.028 [doi]
AB  - OBJECTIVE: To determine the benefits of preoperative breathing exercises on 
      hospital length of stay (LOS), pneumonia, postoperative pulmonary complications 
      (PPC), 6-minute walk distance (6MWD), forced expiratory volume in 1 second 
      (FEV(1)), and health-related quality of life (HRQOL) in patients undergoing 
      surgical lung cancer resection. DATA SOURCES: PubMed, EMBASE, Web of Science Core 
      Collection, and Cochrane Central Register of Controlled Trials were 
      comprehensively searched from inception to March 2021. STUDY SELECTION: Only 
      studies including preoperative inspiratory muscle training (IMT) and/or breathing 
      exercises compared with a nontraining control group were included. The 
      meta-analysis was done using Cochrane software for multiple variables including 
      LOS, pneumonia, PPC, 6MWD, FEV(1), mortality, and HRQOL. DATA EXTRACTION: Two 
      authors extracted the data of the selected studies. The primary outcomes were LOS 
      and PPC. DATA SYNTHESIS: A total of 10 studies were included in this 
      meta-analysis, 8 of which had both IMT and aerobic exercise. Pooled data for 
      patients who performed preoperative breathing exercises, compared with controls, 
      demonstrated a decrease in LOS with a pooled mean difference of -3.44 days (95% 
      confidence interval [CI], -4.14 to -2.75; P<.01). Subgroup analysis also 
      demonstrated that LOS was further reduced when breathing exercises were combined 
      with aerobic exercise (chi(2), 4.85; P=.03). Preoperative breathing exercises 
      reduce pneumonia and PPCs with an odds ratio of 0.37 (95% CI, 0.18-0.75; P<.01) 
      and 0.37 (95% CI, 0.21-0.65; P<.01), respectively. An increase in 6MWD of 20.2 
      meters was noted in those performing breathing exercises (95% CI, 9.12-31.21; 
      P<.01). No significant differences were noted in FEV(1), mortality, or HRQOL. 
      CONCLUSIONS: Preoperative breathing exercises reduced LOS, PPC, and pneumonia and 
      potentially improved 6MWD in patients undergoing surgical lung cancer resection. 
      Breathing exercises in combination with aerobic exercise yielded greater 
      reductions in LOS. Randomized controlled trials are needed to test the 
      feasibility of introducing a preoperative breathing exercise program in this 
      patient population.
CI  - Copyright (c) 2021 The American Congress of Rehabilitation Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Pu, Chan Yeu
AU  - Pu CY
AD  - Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University 
      School of Medicine, Detroit, MI. Electronic address: chanyeu@hotmail.com.
FAU - Batarseh, Hanan
AU  - Batarseh H
AD  - The State University of New York at Buffalo, School of Medicine and Biomedical 
      Sciences, Buffalo, NY.
FAU - Zafron, Michelle L
AU  - Zafron ML
AD  - The State University of New York at Buffalo, The University at Buffalo Libraries, 
      Buffalo, NY.
FAU - Mador, M Jeffery
AU  - Mador MJ
AD  - The State University of New York at Buffalo, School of Medicine and Biomedical 
      Sciences, Buffalo, NY; Division of Pulmonary, Critical Care and Sleep Medicine, 
      Western New York Veterans Health System, Buffalo, NY.
FAU - Yendamuri, Sai
AU  - Yendamuri S
AD  - Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, 
      Buffalo, NY.
FAU - Ray, Andrew D
AU  - Ray AD
AD  - Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer 
      Center, Buffalo, NY.
LA  - eng
GR  - R01 CA222382/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20210427
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Breathing Exercises/*methods
MH  - Forced Expiratory Volume/physiology
MH  - Humans
MH  - Length of Stay
MH  - Lung Neoplasms/*rehabilitation/*surgery
MH  - Pneumonectomy/*methods
MH  - Postoperative Complications/etiology
MH  - Postoperative Period
MH  - Preoperative Period
MH  - Quality of Life
MH  - Walk Test
PMC - PMC9353730
MID - NIHMS1824163
OTO - NOTNLM
OT  - Breathing exercise
OT  - Length of stay
OT  - Pneumonectomy
OT  - Postoperative complications
OT  - Randomized controlled trial
OT  - Rehabilitation
OT  - Thoracotomy
EDAT- 2021/05/01 06:00
MHDA- 2021/12/15 06:00
PMCR- 2022/08/05
CRDT- 2021/04/30 20:18
PHST- 2021/03/23 00:00 [received]
PHST- 2021/03/23 00:00 [accepted]
PHST- 2021/05/01 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/04/30 20:18 [entrez]
PHST- 2022/08/05 00:00 [pmc-release]
AID - S0003-9993(21)00319-1 [pii]
AID - 10.1016/j.apmr.2021.03.028 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2021 Dec;102(12):2416-2427.e4. doi: 
      10.1016/j.apmr.2021.03.028. Epub 2021 Apr 27.