Effects of perioperative exercise interventions on lung cancer patients: An overview of systematic reviews

Aims and Objectives To identify, appraise and summarise systematic reviews of exercise interventions for surgical lung cancer patients. Background Low exercise capacity, reduced pulmonary function, impaired health-related quality of life and postoperative pulmonary complications are common in surgical lung cancer patients. Numerous systematic reviews address these health problems and examine the effects of exercise intervention. However, differences in the quality and scope of the systematic reviews and discordant findings from the reviews make it difficult for decisions-makers to interpret the evidence and establish best practices in the clinical settings. Design Overview of systematic reviews. Methods This overview was conducted following the PRISMA guideline. A literature search of PubMed, CINAHL, EMBASE, Cochrane Library, SPORTDiscus and PEDro was conducted (October 2019). Peer-reviewed systematic reviews of randomised controlled trials focusing on the effects of exercise interventions for lung cancer patients who underwent surgery were included. The methodological quality of included reviews was assessed using AMSTAR 2. The results of reviews with meta-analysis were synthesised and presented by each health outcome. Results Seven systematic reviews published between 2013 and 2019 were included. High/moderate-quality evidence showed that postoperative exercise interventions could increase the exercise capacity and muscle strength, and low/very-low-quality evidence showed that postoperative exercise interventions may increase the physical component of health-related quality of life and decease dyspnoea. Low-quality evidence showed that preoperative exercise interventions may increase exercise capacity and pulmonary function, decrease the risk of postoperative pulmonary complications and reduce the length of hospital stay. Conclusions Postoperative and preoperative exercises have the potential to improve health outcomes in surgical lung cancer patients. Further research is needed to evaluate the effects of different types of exercise and varying amounts of exercise. Relevance to clinical practice This study provides evidence to support the implementation of exercise interventions for surgical lung cancer patients.