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June 2016

17

and nurses, about the role of exercise in lung cancer, as it is

a relatively poorly understood area outside of physiotherapy.

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such an intervention?

Prehabilitation is exercise training conducted before surgery.

There are two clinical rationales for this: (a) it can be used for

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(to maximise their physical status before surgery and reduce

their post-operative morbidity); or (2) for people who are not

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(to improve their physical status enough for them to be able to

receive surgery). Surgical treatment is the best chance of cure for

lung cancer and therefore the ability to train people to help them

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target. However, prehabilitation is a new focus in lung cancer and

the research supporting it is still in its infancy. It is not currently

part of routine practice worldwide, and, at present, we do not

recommend delaying surgery in already-operable patients to

undertake prehabilitation. This is an exciting area of research and

we watch eagerly as results from randomised controlled trials

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What do we know about how exercise training should be

delivered following cancer treatment?

There are several high-quality randomised controlled trials showing

that exercise is effective for patients with lung cancer after curative

treatment (surgery or curative chemotherapy/radiotherapy).

Exercise at this point aims to restore physical status, addressing the

loss of functional capacity and muscle strength which commonly

occurs during treatment, and to maximise function, physical activity

and psychological status in the long term. The evidence shows that

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depression, but does not appear to improve health-related quality of

life or respiratory function at this time point. The exercise programs

in the majority of studies have been in the form of supervised

programs, and generally follow the pulmonary rehabilitation model,

using a combination of aerobic and resistance training, and this

model is currently recommended practice. The addition of other

components, such as breathing exercises, dyspnoea management,

balance exercises and stretches are used occasionally; however,

the independent contribution of these training components to the

resultant outcomes is unknown.

the new

voice

of

PhD Scholarship Round

Opens 4 July

Application information please visit:

www.arthritisvic.org.au/Research/For-Researchers

or contact: 03 8531 8017 |

hana.sabanovic@arthritisvic.org.au

We are seeking a

committed and

enthusiastic PhD scholar

who is interested in

doing musculoskeletal

research in one or more

of the priority areas

outlined in our Research

and Knowledge

Exchange Strategy

Looking forward, what are the key challenges for researchers

undertaking work in this area?

The literature tells us that exercise is important in lung cancer but

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most effective. For example, future research needs to be conducted

to help us understand what type of exercise is best (aerobic,

resistance, combination), and the best dosage/frequency, setting,

etc. In addition, we do not know the best time in the disease’s

trajectory to intervene. This information will help us understand how

to make our treatment most effective for patients.

To access a full transcript of the extended Q&A, email

inmotion@physiotherapy.asn.au

. Go to

physiotherapy.asn.au/

JOP to read issue 2 of the

Journal of Physiotherapy

.