Post-Surgery Walking Program for Lung Cancer

(AIRTECH Trial)

Overseen By Garrett L Walsh

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: M.D. Anderson Cancer Center

Disqualifiers: Cognitive conditions, Pregnant, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

240 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial investigates whether walking after lung cancer surgery can improve recovery and overall quality of life. Participants will use a Fitbit to track their steps, helping researchers understand the link between physical activity and surgical outcomes. The trial includes three groups: one with usual care, one with usual care plus a Fitbit, and one with usual care, a Fitbit, and additional step goals. People who have had lung surgery, own a smartphone, and are not already using a step-tracking device might be a good fit.

As an unphased trial, this study offers participants the chance to contribute to valuable research that could enhance recovery strategies for future patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that walking after surgery is safe for lung cancer patients?

Research has shown that walking soon after surgery can be safe and beneficial for lung cancer patients. For instance, walking just 4 hours after a lobectomy (removal of part of the lung) proved to be a safe way to begin recovery. Another study found that walking on the same day as surgery reduced the likelihood of complications by 30%. Patients who walked early also tended to recover better and experienced fewer issues post-surgery. These findings suggest that getting up and moving soon after surgery is not only safe but also aids in more effective healing. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores how a structured walking program with the aid of technology can enhance recovery after lung cancer surgery. Unlike standard care, which simply encourages patients to exercise more, this approach involves using a Fitbit to monitor and motivate patients' physical activity. The combination of personalized step goals and a supportive group environment using a leaderboard could potentially lead to improved outcomes by actively engaging patients in their recovery process. By integrating digital health tools, the trial aims to find out if this method can accelerate recovery and improve overall well-being compared to traditional advice alone.

What evidence suggests that walking after surgery is effective for improving outcomes in lung cancer patients?

Research has shown that walking soon after lung cancer surgery aids recovery. Studies have found that early walking improves lung function and reduces the risk of complications. Specifically, patients who began walking just hours after surgery recovered more safely and quickly. In this trial, participants will receive varying levels of support for postoperative walking. Some will receive usual care, while others will use a Fitbit to monitor step count, and some will use both a Fitbit and an app to track steps. These tools can encourage more walking, aiding physical recovery. Overall, these findings suggest that moving shortly after surgery is crucial for healing and enhancing quality of life. ^{1 3 5 6 7}

Who Is on the Research Team?

Garrett L. Walsh

Principal Investigator

M.D. Anderson Cancer Center

Are You a Good Fit for This Trial?

This trial is for English-speaking adults over 18 with lung cancer who are ambulatory and scheduled for at least a lobectomy. Participants need a smartphone, internet access, and willingness to use a Fitbit app but shouldn't already be using a device to track steps. Excluded are those with conditions affecting study compliance or understanding, inability to wear an activity monitor at consent time, or pregnancy.

Inclusion Criteria

I was able to walk on my own before surgery.

English speaking

Adequate internet connection via wifi or wireless network connection with smartphone

Exclusion Criteria

Pregnant patients

I am able to understand and follow the study's requirements.

You are unable to wear the activity monitor at the time you agree to participate.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Preoperative

Participants receive education on increasing exercise activity in the preoperative period

1-2 weeks

Postoperative

Participants engage in early ambulation and are monitored using Fitbit devices to track step count and recovery progress

30 days

Daily monitoring with Fitbit, 1 visit at postoperative clinic

Follow-up

Participants are monitored for safety and effectiveness after treatment, including quality of life assessments and postoperative morbidity scores

Up to 30 days after surgery

What Are the Treatments Tested in This Trial?

Interventions

• Walking After Surgery

Trial Overview The AIRTECH Study is testing whether walking after surgery can improve recovery outcomes in lung cancer patients. It involves monitoring walking and sleeping habits through wearable devices like Fitbits and assessing how these activities relate to post-surgical complications and quality of life.

How Is the Trial Designed?

Group I: Arm III (usual care, Fitbit, Fitbit app) Experimental Treatment 5 Interventions

Patients receive usual care consisting of the clinician educating the patient on the importance of increasing exercise activity in the preoperative period and walking in the postoperative setting. Patients also receive a Fitbit device, install and use the Fitbit app on a smartphone. Postoperative step goals are as follows: Postoperative day (POD) 1: 25% of baseline. Subsequent days will be increased by 10% until patient reaches baseline daily step number. Five automatic daily reminders (delivered by the Fitbit Inspire HR\^TM device itself) to meet a minimum of 250 steps an hour. Postoperatively, patients will be invited to participate in a private group with a leaderboard that consists of step numbers of other participants in the study in an anonymous fashion.

Group II: Arm I (usual care) Active Control 3 Interventions

Patients receive usual care consisting of the clinician educating the patient on the importance of increasing exercise activity in the preoperative period and early ambulation in the postoperative setting.

Group III: Arm II (usual care, Fitbit) Active Control 4 Interventions

Patients receive usual care consisting of the clinician educating the patient on the importance of increasing exercise activity in the preoperative period and early ambulation in the postoperative setting. Patients also receive a Fitbit to monitor step count

Who Is Running the Clinical Trial?

M.D. Anderson Cancer Center

Lead Sponsor

Trials

3,107

Recruited

1,813,000+

Published Research Related to This Trial

An early postoperative walking exercise program significantly improved pulmonary and physical functions in lung cancer patients after lobectomy, with better results observed at 1, 3, and 6 months compared to a control group.

The intervention group showed significant improvements in pulmonary function tests (FVC% and FEV1%) at 3 and 6 months post-surgery, although there was no significant difference in overall quality of life between the two groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of an early postoperative walking exercise programme on health status in lung cancer patients recovering from lung lobectomy. Chang, NW., Lin, KC., Lee, SC., et al.[2022]

Preoperative exercise-based interventions significantly improve pulmonary function in lung cancer patients before lung resection surgery, with standardized mean differences indicating meaningful enhancements.

Patients who participated in these exercise programs experienced shorter hospital stays and a reduced risk of postoperative complications, highlighting the intervention's potential to improve recovery outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional and postoperative outcomes after preoperative exercise training in patients with lung cancer: a systematic review and meta-analysis. Sebio Garcia, R., Yáñez Brage, MI., Giménez Moolhuyzen, E., et al.[2022]

In a study of 68 patients aged around 70 years who underwent lung resection, those who received 2 weeks of postoperative inspiratory muscle training (IMT) reported significantly less sedentary behavior and higher levels of moderate activity compared to the control group.

While IMT helped maintain physical activity levels post-surgery, it did not show a significant difference in overall health status as measured by the EQ-5D-5L questionnaire, indicating that while activity improved, overall health perception may need further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Inspiratory Muscle Training in High-Risk Patients Following Lung Resection May Prevent a Postoperative Decline in Physical Activity Level. Brocki, BC., Andreasen, JJ., Westerdahl, E.[2019]

The Progressive Walking program (PW) significantly improved physical activity levels and exercise tolerance in patients after lung resection, with participants walking longer distances and experiencing less shortness of breath compared to the control group.

Patients in the PW group had shorter hospital stays and less time with chest tubes, indicating that this program may enhance recovery without increasing the risk of pulmonary complications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effects of a progressive walking program on physical activity, exercise tolerance, recovery, and post-operative complications in patients with a lung resection]. Kim, I., Lee, H.[2015]

This study will assess the effectiveness of a 12-week home-based exercise and self-management program for lung cancer patients post-surgery, comparing it to usual care in a randomized controlled trial with 112 participants.

The primary outcome is improvement in physical function, measured by the EORTC QLQ c30 questionnaire, with secondary outcomes including health-related quality of life and exercise capacity, evaluated over 12 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of a postoperative home-based exercise and self-management programme on physical function in people with lung cancer (CAPACITY): protocol for a randomised controlled trial. Granger, CL., Edbrooke, L., Antippa, P., et al.[2022]

In a study of 107 patients undergoing lung cancer surgery, in-hospital physiotherapy did not lead to significant improvements in physical capacity, physical activity, or lung function compared to a control group after 3 months.

However, patients who received physiotherapy reported an increase in their self-reported physical activity levels post-surgery, suggesting some benefit in perceived activity despite no measurable differences in physical capacity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In-Hospital Physiotherapy and Physical Recovery 3 Months After Lung Cancer Surgery: A Randomized Controlled Trial. Jonsson, M., Ahlsson, A., Hurtig-Wennlöf, A., et al.[2020]

Postoperative exercise training significantly improves the quality of life (QoL) for patients after lung surgery, as shown by increased scores in both physical and mental domains of the SF-36 health survey across eight studies with 691 participants.

However, the same exercise training did not show significant improvements in exercise capacity or respiratory function, indicating that while QoL benefits are clear, further research is needed to explore its effects on other clinical outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Postoperative exercise training improves the quality of life in patients receiving pulmonary resection: A systematic review and meta-analysis based on randomized controlled trials. Wang, J., Dong, Y., Su, J., et al.[2022]

In a study of 109 elderly lung cancer patients, those who participated in enhanced recovery after surgery-based respiratory function exercises showed significant improvements in respiratory function and overall quality of life compared to those receiving only conventional care.

The exercise program also led to a lower incidence of pulmonary complications (5.26% in the exercise group vs. 21.15% in the control group), highlighting its effectiveness in promoting safer postoperative recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Enhanced Recovery After Surgery-Based Respiratory Function Exercise in Elderly Patients with Lung Cancer and its Effect on Postoperative Functional Recovery. Du, J., Wu, C., Li, A., et al.[2023]

Pre-surgery exercise interventions significantly improve physical and pulmonary function in lung cancer patients, which can enhance their ability to undergo surgery and reduce complications afterward.

Post-surgery exercise interventions show inconsistent results, with some studies reporting no significant effects, highlighting the need for more research on the timing and setting of exercise programs in lung cancer care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise and lung cancer surgery: A systematic review of randomized-controlled trials. Himbert, C., Klossner, N., Coletta, AM., et al.[2023]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/24646333/

Effects of an early postoperative walking exercise ... This study demonstrated the benefits of an early postoperative walking exercise intervention for pulmonary and physical function in postlobectomy lung cancer ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10091666/

Early ambulation and postoperative recovery of patients with ... Early ambulation within 24 h after thoracoscopic surgery for lung cancer patients can promote the recovery of intestinal function, early removal of chest tube.

3. sciencedirect.com sciencedirect.com/science/article/pii/S0022522325001734

The effect of multimodal prehabilitation on postoperative ... Multimodal prehabilitation significantly reduced overall and major postoperative 30-day complications in lung cancer surgery.

4. link.springer.com link.springer.com/article/10.1007/s11748-007-0169-8

Early postoperative mobilization with walking at 4 hours ... Conclusion. Walking at 4 h after lobectomy in patients with non-small-cell lung cancers is a safe approach to starting pulmonary rehabilitation after surgery.

5. jtd.amegroups.org jtd.amegroups.org/article/view/93337/html

Postoperative day of surgery ambulation improves outcomes ... Conclusions: Patients who ambulated postoperatively on the day of surgery had better surgical recovery and outcomes after lung resection than those who did not.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12378839/

Relationship between walking distance within the first 24 h ... This study examined the relationship between early postoperative walking distance and clinical outcomes in patients who underwent lung cancer ...

7. news.cuanschutz.edu news.cuanschutz.edu/department-of-surgery/benefit-of-early-ambulation-after-lung-surgery

CU Department of Surgery Research Shows Benefit ... What they found was impressive: The patients who walked the same day were 30% less likely to have complications from the procedure and 23% less ...