The Effect of Pulmonary Rehabilitation on Pulmonary Function Tests, Exercise Capacity, and Quality of Life in Patients With Advanced-Stage Lung Cancer Receiving Chemotherapy

NCT07532057 | Completed

• 1 other identifier: HALIC-EC-109-2018
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

This randomised controlled trial investigated the effects of an 8-week physiotherapist-supervised pulmonary rehabilitation (PR) programme on pulmonary function tests (PFT), exercise capacity, and health-related quality of life (HRQoL) in patients with advanced-stage lung cancer (Stage IIIB/IV) receiving chemotherapy. Thirty patients were randomised to a PR group (n=15) or a home-programme control group (n=15). The PR group underwent twice-daily supervised sessions comprising postural drainage with breathing exercises, bronchial clearance techniques, active cycle of breathing technique (ACBT), effective coughing manoeuvres, and strengthening exercises - plus home aerobic walking 20 min/day. The control group performed home-based breathing and coughing exercises twice daily. Results: The PR group showed significant improvements in 6MWT (+85.8 m; p=0.001), FVC, FEV1, PEF (all p=0.001), and all 8 LCSS symptom domains (p=0.001). The control group showed significant declines in FEV1, PEF, 6MWT, and worsening quality of life. Between-group differences were significant for all primary outcomes (p≤0.001).

Conditions

Cancer; Lung Neoplasms; Lung Cancer Small Cell Lung Cancer (SCLC)

Outcome Measures

Primary Outcomes (4)

• Change in Exercise Capacity (6-Minute Walk Test - 6MWT)

  The 6MWT was used to evaluate functional exercise capacity. The change in walking distance after 8 weeks was compared between the two groups.

  Baseline and after 8 weeks

• Forced Vital Capacity (FVC)

  FVC (litres) by spirometry (COSMED), ATS/ERS standards, best of three.

  Baseline and Week 8

• Forced Expiratory Volume in 1 Second (FEV1)

  Baseline and Week 8

• Peak Expiratory Flow (PEF)

  Baseline and Week 8

Secondary Outcomes (3)

• Change in Quality of Life (Lung Cancer Symptom Scale - LCSS)

  Baseline and after 8 weeks

• FEV1/FVC Ratio and FEF25-75%

  Baseline and Week 8

• Mini-Mental State Examination (MMSE) Score

  Baseline and Week 8

Study Arms (2)

Treatment Group (Pulmonary Rehabilitation Group)

EXPERIMENTAL

Physiotherapist-supervised pulmonary rehabilitation programme for 8 weeks, twice daily. Components: postural drainage with 20-rep breathing exercises, bronchial clearance techniques (percussion/vibration/shaking), ACBT, effective coughing/huffing, progressive strengthening exercises. Home programme: same exercises 2×/day + aerobic walking 20 min/day.

Behavioral: Supervised Pulmonary Rehabilitation

Control Arm (Home Exercise Program Group)

ACTIVE COMPARATOR

Unsupervised home-based programme of diaphragmatic breathing exercises and effective coughing techniques, twice daily for 8 weeks. No supervised sessions. No aerobic walking.

Behavioral: Home-Based Breathing Exercises

Interventions

Supervised Pulmonary Rehabilitation BEHAVIORAL

8-week, twice-daily programme supervised by a licensed physiotherapist. Components: (1) Postural drainage + diaphragmatic/thoracic breathing exercises (20 reps); (2) Manual bronchial clearance: percussion, vibration, shaking; (3) ACBT: breathing control → thoracic expansion exercises → forced expiration technique (huff); (4) Effective coughing manoeuvres; (5) Progressive resistance/strengthening exercises (upper and lower limbs); (6) Home aerobic walking: 20 min/day at Borg RPE 11-13/20. Session stopped if SpO2 \< 88%.

Treatment Group (Pulmonary Rehabilitation Group)

Home-Based Breathing Exercises BEHAVIORAL

Patients in this group received breathing exercises and effective coughing techniques as part of a home-based rehabilitation program. The intervention included: Breathing exercises Effective coughing techniques Patients were instructed to perform these exercises twice daily at home for 8 weeks without physiotherapist supervision.

Control Arm (Home Exercise Program Group)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Histologically confirmed lung cancer (any histological subtype), Stage IIIB or Stage IV Receiving or scheduled to receive chemotherapy (≤3 cycles completed at enrolment) Age ≥ 18 years ECOG Performance Status 0, 1, or 2 MMSE score ≥ 24/30 (adequate cognitive function) Written informed consent provided

You may not qualify if:

• Lung cancer Stage I or II (operable disease) Any complication contraindicating pulmonary rehabilitation (including pathological bone fracture, open wound, unstable cardiac disease, active uncontrolled infection) Inability or refusal to provide written informed consent

Sponsors & Collaborators

• Istanbul Medipol University Hospital: lead
• Halic University: collaborator

Study Sites (1)

Istanbul Medipol University

Istanbul, Kavacik, 34000, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Neoplasms; Lung Neoplasms; Small Cell Lung Carcinoma

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Lung Diseases; Respiratory Tract Diseases; Carcinoma, Bronchogenic; Bronchial Neoplasms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer

Study Record Dates

• First Submitted: April 8, 2026
• First Posted: April 15, 2026
• Study Start: November 1, 2018
• Primary Completion: May 30, 2019
• Study Completion: May 30, 2019
• Last Updated: April 16, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)