HOME REHABILITATION FOR PREOPERATIVE THORACOTOMY PATIENTS

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We investigated whether home rehabilitation (rehab) can improve pulmonary function and exercise capacity in preoperative thoracotomy patients. Fourteen preoperative lung cancer patients (68(]SY.+-[)5yr) were included in this study. Number of one-day walking step (WS) was measured with an odometer for a week and a mean of the WS was calculated. The patients were encouraged to walk at home two times or more than the mean WS.Before and after the rehab a pulmonary function test and 3-min.incremental exercise test were administered. Eight patients who demonstrated 5% or more improvement in maxVO<@D22@>D2 or blood lactate threshold were categorized to an effective group (E) and 6 patients who did not were categorized to a non-effective group (NON). The short duration of rehab, insufficient increase in the WS,progress of lung cancer, and associated heart disease were thought to be causes of failure of the home hehabilitation. In the E group, the WS during rehab.was 2.5(]SY.+-[)1.8 times of the pre-rehab WS.The duration of rehab was 29(]SY.+-[)7 days. FVC (3.04(]SY.+-[)1.00-->3.25(]SY.+-[)0.93L,p=0.02) and VC (3.13(]SY.+-[)0.97-->3.35(]SY.+-[)0.99L,p=0.0018) increased significantly after rehab. but FEV1.0 (1.90(]SY.+-[)0.70-->1.94(]SY.+-[)0.68L/s) and MVV (73.1(]SY.+-[)26.3-->75.2(]SY.+-[)27.7L/min) did not. MaxVO<@D22@>D2/BSA (623(]SY.+-[)181-->705(]SY.+-[)168ml/min./m<@D12@>D1 ; p=0.0003), maxO<@D22@>D2 pulse (4.64(]SY.+-[)1.23-->5.17(]SY.+-[)1.13ml/beat/m<@D12@>D1 ; p=0.0011) and blood lactate threshold (452(]SY.+-[)88-->504(]SY.+-[)108ml/min./m<@D12@>D1 ; p=0.0052) significantly increased after the rehab. We conclude that home rehabilitation for about a month using an odometer may improve exercise capacity in preoperative thoracotomy patients.