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It has been observed that there are negative effects on respiratory muscle strength following lobectomy. This has led to the necessity of respiratory muscle training to mitigate these adverse effects. Most studies conducted so far focus on the late postoperative period, and there are only a few studies evaluating the effectiveness of early postoperative inspiratory muscle training (IMT). It is believed that this method could be useful for facilitating patient follow-up and increasing patient motivation through visual feedback.
It has been observed that there are negative effects on respiratory muscle strength following lobectomy. This has led to the necessity of respiratory muscle training to mitigate these adverse effects. Most studies conducted so far focus on the late postoperative period, and there are only a few studies evaluating the effectiveness of early postoperative inspiratory muscle training (IMT). Additionally, there is currently no study assessing the effectiveness of IMT using a smart adapter in patients who have undergone lobectomy. It is believed that this method could be useful for facilitating patient follow-up and increasing patient motivation through visual feedback. The aim of this study is to examine the changes in respiratory muscle strength and exercise capacity in patients after lobectomy via VATS, comparing classical IMT, mobile application-supported IMT, and a control group that does not receive IMT.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Classic IMT | Active Comparator | Individuals who are between the ages of 18-65 and lung cancer patient, underwent lobectomy with video-assisted thoracic surgery. The group will receive standard postoperative physiotherapy and rehabilitation as well as classical inspiratory muscle strength training with the noninvasive Powerbreath Medic Plus device (POWERbreathe International Ltd., Warwickshire, England). Training will start with 40 percent of the initial MIP level and progress will be planned according to Modified Borg between 3-4. It will be repeated twice a day for 3 times 10 minutes. Training will start on the 1st postoperative day after the participants are transferred to the ward and they will be asked to continue at home. The progress plan will be adjusted by talking to the patient on the phone every 2 days after discharge. |
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| IMT with mobile application | Experimental | Individuals who are between the ages of 18-65 and lung cancer patient, underwent lobectomy with video-assisted thoracic surgery. The group will receive standard postoperative physiotherapy and rehabilitation as well as inspiratory muscle training with the smart adapter support (POWERbreathe International Ltd., Warwickshire, England). Training will start with 40 percent of the initial MIP level and progress will be planned according to Modified Borg between 3-4. It will be repeated twice a day for 3 times 10 minutes. Training will start on the 1st postoperative day after the participants are transferred to the ward and they will be asked to continue at home. The progress plan will be adjusted by talking to the patient on the phone every 2 days after discharge. |
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| control group | No Intervention | Individuals who are between the ages of 18-65 and lung cancer patient, underwent lobectomy with video-assisted thoracic surgery. This group will receive only standard physiotherapy and rehabilitation: respiratory exercises (thoracic expansion exercises, diaphragmatic breathing, incentive spirometry), mobilization and cough/huffing training. Participants will be advised to continue these exercises regularly at home. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| inspiratory muscle exercise | Other | Inspiratory muscle training will be given with or without smart adaptor. |
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| Measure | Description | Time Frame |
|---|---|---|
| Inspiratory muscle strength | Respiratory muscle strength will measure by measuring mouth pressure and using maximal inspiratory pressure (MIP) values. | Measurements will be performed before surgery (the day before surgery), at discharge and during the follow-up period after surgery (10-15 days after discharge). |
| Expiratory muscle strength | Respiratory muscle strength will measure by measuring mouth pressure and using maximal expiratory pressure (MEP) values. | Measurements will be performed before surgery (the day before surgery), at discharge and during the follow-up period after surgery (10-15 days after discharge). |
| Measure | Description | Time Frame |
|---|---|---|
| Functional exercise capacity | 6-minute walk test (6MWT) will be used to evaluate functional exercise capacity. | Evaluations will be made before surgery (the day before surgery) and during the follow-up period (10-15 days after discharge). |
| Postoperative Pulmonary Complications |
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Inclusion Criteria:
Exclusion criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Funda Alma, MsC | Contact | +905079394348 | fundasirakaya@outlook.com | |
| Ebru Calik Kutukcu, Professor | Contact | +905442850087 | ebru.calik@hacettepe.edu.tr |
| Name | Affiliation | Role |
|---|---|---|
| Ebru Calik Kutukcu, Professorr | Hacettepe University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe University | Ankara | 06100 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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double blind (participant and statistician)
Postoperative pulmonary complications will be evaulate by Melbourne Group Scale. If more than 4 parameters are positive, it will be considered as having postoperative pulmonary complication. |
| Postoperative first-fifth days. |
| Exercise Motivation | Exercise Motivation Attitude Scale will be used. This scale consists of 3 sub-dimensions (negative attitude and thought/positive view and health/physical appearance and health). | The evaluation will be made during the control period (10-15 days after discharge). |
| Dyspnea Level | Modified Borg Scale will be used to evaluate dyspnea. | An evaluation will be made in the preoperative (the day before surgery) and control period (10-15 days after discharge). |
| Quality of Life | SF-12 Quality of Life Scale will be used to assess quality of life. | The evaluation will be made during the preoerative (the day before surgery) and control (10-15 days after discharge) period. |
| Physical Performance | The Short Physical Performance Battery, a frequently used test in cardiovascular and pulmonary diseases, will be used. | Evaluations will be made in the preoperative (the day before surgery) and control (10-15 days after discharge) periods. |
| D008171 |
| Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |