Grant: Travel Awards - Institute Community Support

Background: Many persons with lung cancer lose functional capacity and muscle, are fatigued and have more difficulties performing their normal activities. Those who undergo surgery in these conditions suffer from more complications, take more time to recover and have more risk of mortality. Our aim is to determine if a multimodal prehabilitation program (exercise, nutrition and anxiety reducing strategies) for four weeks before surgery can improve functional recovery after surgery. Methods: Adult lung cancer patients going for surgery received a multimodal prehabilitation program consisting of home-based moderate intensity exercise, nutritional counseling with whey protein supplementation and anxiety reducing strategies, either before (PREHAB, n=52) or after surgery (REHAB, n=52). Change in functional capacity, determined by the six-minute walk test (6MWT), was measured at baseline, immediately prior to surgery, and at four and eight weeks after surgery. Results: The 6MWT was significantly different between groups before surgery (PREHAB 27.6 (49.9) vs. REHAB 3.0 (81.6) meters, P= 0.0197). No significant differences in 6MWT were detected between groups after surgery, however, a greater proportion of patients in the PREHAB group recovered to baseline functional capacity by four weeks after surgery (PREHAB 60% vs. REHAB 30%, P=0.096). Both groups returned to baseline functional capacity by eight weeks after surgery. Patients in the PREHAB group had a significantly lower length of hospital stay compared to the REHAB group (PREHAB 3.6 (2.2) vs. REHAB 7.2 (11.5) days, P<0.0001). Conclusion: In patients undergoing lung cancer surgery, multimodal prehabilitation for four weeks before surgery resulted in a significant improvement in preoperative functional capacity, a shorter length of hospital stay and early recovery by four weeks after surgery.