Pulmonary Rehabiltation before Lung Cancer Resection

肺癌切除前的肺康复

• 批准号: 8216424
• 负责人: Roberto Pablo Benzo
• 金额: $ 35.15万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8216424
• 关键词: Air; Atelectasis; Behavior; Behavior Therapy; Blinded; Breathing; Chest; Chronic Care; Chronic Obstructive Airway Disease; Clinic; Control Groups; Coronary Artery Bypass; Data; Disease; Disease Progression; Drainage procedure; Effectiveness; Excision; Exercise; Funding; Generic Drugs; Goals; Intervention; Length of Stay; Lung; Malignant Neoplasms; Malignant neoplasm of esophagus; Malignant neoplasm of lung; Measures; Mechanical ventilation; Mediator of activation protein; Methods; Minnesota; Monitor; Morbidity - disease rate; Muscle; National Cancer Institute; Non-Small-Cell Lung Carcinoma; Operative Surgical Procedures; Outcome; Patients; Perioperative Care; Physical activity; Pneumonia; Population; Postoperative Complications; Postoperative Period; Preoperative Care; Process; Protocols documentation; Quality of life; Questionnaires; Randomized; Recovery; Rehabilitation therapy; Research; Resectable; Resected; Respiratory Failure; Respiratory Muscles; Respiratory physiology; Risk; Saints; Self Assessment; Self Efficacy; Solid; Testing; Thoracic Surgical Procedures; Training; Translating; United States; Universities; Washington; Woman; Work; analog; cancer therapy; design; improved; innovation; insight; intervention effect; men; psychologic; respiratory; success

DESCRIPTION (provided by applicant): The overall objective of this proposal is to obtain definitive evidence for the effectiveness of a short preoperative Pulmonary Rehabilitation on the morbidity and recovery from a curative surgical resection in patients with Lung Cancer and severe Chronic Obstructive Pulmonary Disease (COPD). The long term goal of this research agenda is to innovate the preoperative care of lung cancer resection in patients with low lung function, and ultimately translate these improvements to all thoracic surgical procedures (such as esophageal cancer, coronary artery bypass surgery, etc.) and to impact on quality of life and physical activity trajectory, proposed mediators of lung cancer survival. The rationale for the need of this research is the lack any well proven risk-reducing intervention that may decrease the morbidity of lung cancer resection in patients with severe COPD or that may improve their quality of life or physical activity trajectory, meaningful variables in the overall disease progression. The proposed intervention is unique as it combines exercise and behavioral interventions that were pilot tested in a randomized single-blinded controlled design in the proposed population and proved feasible and potentially effective. This application brings together solid preliminary data with centers of excellence in Pulmonary Rehabilitation and thoracic surgery to conduct a study that will advance the field of preoperative and chronic care. We will describe the process of rehabilitation and recovery in-depth, test our hypotheses, and achieve the objective of this application by pursuing the following specific aims: Specific Aim 1: To prospectively determine the effect of 10 sessions of customized preoperative Pulmonary Rehabilitation on length of hospital stay and on the number of postoperative complications in patients that undergo a lung cancer resection and have severe COPD compared to a matched control group. Hypothesis: Ten sessions of customized preoperative Pulmonary Rehabilitation will significantly reduce the length of hospital stay and the number of postoperative pulmonary complications. Specific Aim 2: To prospectively determine the effect of a 10-session preoperative Pulmonary Rehabilitation on the trajectory of quality of life and measured physical activity at 3, 6 and 12 month after the curative resection compared to a matched control group. Hypothesis: Ten sessions of customized preoperative Pulmonary Rehabilitation will significantly and meaningfully (more than the minimal clinically important difference) improve physical activity and quality of life after surgery compared to a control group. PUBLIC HEALTH RELEVANCE: The overall objective of this proposal is to obtain definitive evidence for the effectiveness of a short preoperative Pulmonary Rehabilitation on the morbidity and recovery from a curative surgical resection in patients with Lung Cancer and severe Chronic Obstructive Pulmonary Disease (COPD).

描述（由申请人提供）：本提案的总体目标是获得明确的证据，证明短期术前肺康复对肺癌和严重慢性阻塞性肺疾病 (COPD) 患者治愈性手术切除的发病率和恢复情况的有效性）。该研究议程的长期目标是创新低肺功能患者肺癌切除术的术前护理，并最终将这些改进转化为所有胸外科手术（如食管癌、冠状动脉搭桥手术等）和为了影响生活质量和身体活动轨迹，提出了肺癌生存的中介因素。需要这项研究的理由是，缺乏任何经过充分证明的降低风险的干预措施，可以降低严重慢性阻塞性肺病患者肺癌切除的发病率，或者可以改善他们的生活质量或体力活动轨迹，这些变量在总体上是有意义的。疾病进展。拟议的干预措施是独一无二的，因为它结合了运动和行为干预措施，并在拟议人群中以随机单盲对照设计进行了试点测试，并证明是可行的且可能有效。该应用程序汇集了肺康复和​​胸外科卓越中心可靠的初步数据，开展一项研究，推动术前和慢性护理领域的发展。我们将深入描述康复和恢复的过程，检验我们的假设，并通过追求以下具体目标来实现本应用的目标： 具体目标 1：前瞻性地确定 10 次定制术前肺康复对时长的影响与匹配的对照组相比，接受肺癌切除术并患有严重慢性阻塞性肺病的患者的住院时间和术后并发症的数量。假设：十次定制的术前肺康复将显着减少住院时间和术后肺部并发症的数量。具体目标 2：与匹配的对照组相比，前瞻性地确定 10 个疗程的术前肺康复对治疗性切除术后 3、6 和 12 个月的生活质量和测量的体力活动的影响。假设：与对照组相比，十次定制的术前肺康复将显着且有意义（超过最小的临床重要差异）改善术后身体活动和生活质量。 公共健康相关性：本提案的总体目标是获得明确的证据，证明短期术前肺康复对肺癌和严重慢性阻塞性肺病 (COPD) 患者治愈性手术切除的发病率和恢复的有效性。