Can Wearable Devices Support Recovery After NSCLC Surgery?

TOPLINE:

A recent analysis, evaluating an intervention in which patients with non–small cell lung cancer (NSCLC) used a wearable device to help monitor exercise post-surgery, found that participants reported an increase in daily steps and vigorous activities as well as less dyspnea and pain compared with those receiving usual care after surgery. The intervention, however, did not appear to lead to improvements in patients’ cardiopulmonary function.

METHODOLOGY:

• Patients with NSCLC often experience decreased cardiopulmonary function and physical activity post-surgery. Emerging evidence suggests wearable devices can support rehabilitation by monitoring activity and encouraging exercise.
• To evaluate whether a personalized exercise program that incorporated wearable devices could improve recovery compared with usual care, researchers performed a single-center, nonrandomized clinical trial between 2018 and 2019 in Seoul, which involved 194 patients with NSCLC who underwent curative surgery.
• In total, 74 patients (mean age, 60.4 years; 58.1% women) followed a three-phase exercise program — preoperative, immediate postoperative, and late postoperative — monitored through a wearable device (a Fitbit), and 120 patients (mean age, 60.2 years; 45.8% women) received usual care. Usual care included walking and other activities aimed at improving respiratory health, but participants did not receive individual guidance on preoperative and postoperative exercises.
• Primary outcomes were cardiopulmonary function and physical activity, measured by 6-minute walking distance and daily steps, and secondary outcomes assessed health-related quality-of-life and symptoms at 2 weeks and 6 months post-surgery.
• Cardiopulmonary function was assessed using the 6-minute walking distance test, in which participants walked back and forth along a corridor as quickly as possible in 6 minutes.

TAKEAWAY:

• Overall, at 6 months, patients in the intervention group tracked significantly more average steps per day than those in the usual care group (12,321 vs 10,118; P = .007). However, patients’ 6-minute walking distance at 6 months — the main assessment of cardiopulmonary function — was not significantly different between the groups (mean, 536 vs 513, respectively; P = .12).
• Patients who used a wearable device reported a significant increase in their daily steps — 2220 more — from their pre-surgery baseline, while those who received usual care did not regain their baseline daily step count, reporting a decrease of 586 steps per day.
• Patients in the intervention group engaged in significantly more vigorous physical activity (33.6 minutes vs 18.5 minutes in the usual care group; P = .003).
• Similarly, patients who used the wearable device reported higher physical function (mean score, 82.2 vs 76.9; P = .04), less dyspnea (mean score, 5.4 vs 12; P = .01), and less pain (mean score, 21.4 vs 30.1; P = .01) at 2 weeks post-surgery.

IN PRACTICE:

In this study, patients who participated in an exercise program that included personalized activity monitoring with a wearable device “showed improvement in postoperative physical activity and related patient-reported outcomes after lung cancer surgery compared with those who received standard postoperative care,” the researchers concluded.

These findings highlight “the potential of wearable-based physical-tracking monitors to improve postoperative lung cancer care,” the authors of an accompanying editorial wrote.

SOURCE:

The study, led by Junghee Lee, MD, Samsung Medical Center, Sungkyunkwan University School of Medicine in Seoul, South Korea, was published online in JAMA Network Open.

LIMITATIONS:

The study was conducted at a single center in South Korea, which may limit the generalizability of the results to other populations. The nonrandomized design introduces the possibility of maturation bias. Use of different wearable devices to measure outcomes at 2 weeks post-surgery could affect the consistency of the data.

DISCLOSURES:

The study was supported by grants from the National Research Foundation of Korea, funded by the Korea Ministry of Science and ICT and the Institution of Quality of Life in Cancer, funded by Samsung Fire & Marine Insurance. No relevant conflicts of interest were disclosed by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.