Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 26, 2024
Date Accepted: Sep 25, 2024
Effectiveness and feasibility of digital pulmonary rehabilitation in patients undergoing lung cancer surgery: systematic review and meta-analysis
ABSTRACT
Background:
Pulmonary rehabilitation has identified as an effectiveness intervention facilitating the recovery of patients undergoing lung cancer surgery across various phases. Digital rehabilitation programs offer a solution to challenges, such as time and space limitations, faced by traditional approaches. It remains unclear whether digital pulmonary rehabilitation benefits lung cancer patients undergoing surgery.
Objective:
To evaluate the feasibility and effectiveness of digital pulmonary rehabilitation programs for individuals undergoing lung cancer surgery.
Methods:
Six English and four Chinese databases were retrieved from inception to January 1st, 2024, and references in related studies were manually reviewed. Primary outcomes included physical capacity, lung function, and incidence of postoperative pulmonary complications. Secondary outcomes encompassed compliance, hospital stay, chest tube duration, anxiety, depression, and quality of life. Recruitment and withdraw rate also were assessed if possible. Meta-analyses and descriptive analyses were employed as appropriate.
Results:
Five randomized controlled trials and six quasi-experimental studies were included. Meta-analyses of four studies indicated that internet-based perioperative pulmonary rehabilitation programs significantly improved the 6-minute walk distance [MD= 15.00, 95%CI= 4.34 to 25.65, p= 0.006], reduced the incidence of postoperative pulmonary complications [OR= 0.36, 95%CI= 1.91 to 5.91, p< 0.001], and shortened the duration of chest tube indwelling [MD= 1.53, 95%CI= 0.12 to 2.95, p= 0.03] compared to the traditional interventions. Despite low attendance (< 70%) during the recruitment stage, digital pulmonary rehabilitation program,improved exercise compliance, increased patient satisfaction, and reduced withdraw compared with the usual program. No adverse events were reported.
Conclusions:
This systematic review provides synthesized evidence on the safety, feasibility, and potential efficacy of digital-based pulmonary rehabilitation programs for lung cancer surgery patients. These results suggest that digital-based pulmonary rehabilitation can serve as a valuable supplementary approach to enhance patients' recovery from lung cancer surgery. Clinical Trial: CRD42023430271
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