Browsing by Author "Martins, Raul A."
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- ASO Author Reflections: Impact of a Preoperative Home-Based Exercise Program on Quality of Life After Lung Cancer ResectionPublication . Machado, Pedro; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaSurgical resection is the cornerstone of curative treatment for patients with lung cancer. Nevertheless, it often leads to functional limitations and symptoms of pain, fatigue, and dyspnea, which have a detrimental impact on patients’ health-related quality of life (HRQoL).
- ASO Visual Abstract: Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled TrialPublication . Machado, Pedro; Pimenta, Sara; Garcia, Ana Luís; Nogueira, Tiago; Silva, Sónia; Santos, Claúdia Lares dos; Martins, Maria Vitória; Canha, André; Oliveiros, Bárbara; Martins, Raul A.; Cruz, Joana
- Effect of Exercise Training on Quality of Life after Colorectal and Lung Cancer Surgery: A Meta-AnalysisPublication . Machado, Pedro; Pimenta, Sara; Oliveiros, Bárbara; Ferreira, José Pedro; Martins, Raul A.; Cruz, JoanaSurgical treatment affects health-related quality of life (HRQoL) and increases fatigue symptoms in patients with lung cancer (LC) and colorectal cancer (CRC). We aimed to systematically review the effect of exercise training on HRQoL and fatigue after LC and CRC surgery. Randomized controlled trials published before 21 March 2021, were searched in PubMed, Scopus, Web of Science, SPORTDiscus and PEDro. Eligible trials compared the effect of exercise interventions initiated preoperatively or in the first 3 months after surgery versus usual care on postoperative HRQoL and fatigue. Standardized mean differences (SMD) were pooled using random-effects models. Twelve studies with a total of 777 patients were included. In LC patients (10 studies, n = 651), exercise training in general led to a moderate improvement in the physical domain of HRQoL (0.68: 95% CI: [0.47; 0.89]) and a small reduction in fatigue levels after surgery (SMD = 0.28: 95% CI: [0.02; 0.53]), while no effects were found in other HRQoL domains. In CRC (two studies, n = 126), exercise training showed no effects on HRQoL and fatigue after surgery. Exercise training is an effective intervention to improve physical function and fatigue after LC surgery. Further studies are necessary to clarify the effects of exercise on HRQoL and fatigue after CRC surgery.
- Effect of home-based exercise prehabilitation on postoperative outcomes in colorectal cancer surgery: a systematic review and meta-analysisPublication . Machado, Pedro; Paixão, André; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaPurpose Home-based exercise training may improve access to surgical prehabilitation in colorectal cancer (CRC) patients, but its efficacy remains unclear. This study systematically investigated the effects of home-based exercise prehabilitation on postoperative exercise capacity, complications, length of hospital stay, and health-related quality of life (HRQoL) in CRC patients. Methods Randomized controlled trials (RCTs) comparing home-based exercise prehabilitation with control in CRC patients were eligible. We searched MEDLINE, Scopus, Web of Science, PEDro, and SPORTDiscus from their inception to June 3, 2024. Methodological quality was assessed using the PEDro scale, and certainty of evidence was assessed using GRADE. Data were synthesized using random-effects meta-analyses, with sensitivity analysis on studies with good methodological quality (PEDro score ≥ 6). Results Eight RCTs involving 1092 participants were included. The primary analysis showed a significant improvement in postoperative 6-min walk distance following home-based exercise prehabilitation compared to control (mean difference (MD) = 30.62: 95% CI: [2.94; 57.79]; low-certainty evidence). However, sensitivity analysis revealed no significant between-group differences (MD = 22.60: 95% CI: [− 6.27; 51.46]). No significant effects of home-based exercise prehabilitation were found on postoperative complications (risk ratio = 1.00: 95% CI: [− 0.78; 1.29]; moderate‐certainty evidence), length of hospital stay (MD = − 0.20: 95% CI: [− 0.65; 0.23]; moderate‐certainty evidence), and HRQoL (physical functioning: MD = 2.62: 95% CI: [− 6.16; 11.39]; mental functioning: MD = 1.35: 95% CI: [− 6.95; 9.65]; low and very-low certainty evidence). Conclusion Home-based exercise prehabilitation does not reduce postoperative complications and length of hospital stay after CRC surgery. Its effects on postoperative exercise capacity and HRQoL remain uncertain due to low-quality evidence.
- Effect of Preoperative Home-Based Exercise Training on Quality of Life After Lung Cancer Surgery: A Multicenter Randomized Controlled TrialPublication . Machado, Pedro; Pimenta, Sara; Garcia, Ana Luís; Nogueira, Tiago; Silva, Sónia; Santos, Cláudia Lares dos; Martins, Maria Vitória; Canha, André; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaBackground. Preoperative exercise training is recommended for improvement of clinical outcomes after lung cancer (LC) surgery. However, its efectiveness in preventing postoperative decline in quality of life (QoL) remains unknown. This study investigated the efect of preoperative home-based exercise training (PHET) on QoL after LC surgery. Methods. Patients awaiting LC resection were randomized to PHET or a control group (CG). The PHET program combined aerobic and resistance exercise, with weekly telephone supervision. Primary outcome was QoL-assessed with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 (QLQC30) at baseline, before surgery, and 1 month after surgery. The secondary outcomes were hospital length of stay and physical performance. The main analysis included a factorial repeated-measures analysis of variance. Additionally, the proportion of patients experiencing clinical deterioration from baseline to post-surgery was assessed. Results. The study included 41 patients (68.1±9.3 years; 68.3% male) in the intention-to-treat analysis (20 PHET patients, 21 CG patients). A signifcant group × time interaction was observed for global QoL (p =0.004). Betweengroup diferences in global QoL were statistically and clinically signifcant before surgery (mean diference [MD], 13.5 points; 95% confdence interval [CI], 2.4–24.6; p =0.019) and after surgery (MD, 12.4 points; 95% CI, 1.3–23.4; p=0.029), favoring PHET. Clinical deterioration of global QoL was reported by 71.4% of the CG patients compared with 30 % of the PHET patients (p =0.003). Between-group diferences in favor of PHET were found in pain and appetite loss as well as in physical, emotional and role functions after surgery (p <0.05). Compared with CG, PHET was superior in improving preoperative fve-times sit-to-stand and postoperative exercise capacity (p <0.05). No between-group diferences in other secondary outcomes were observed. Conclusion. The study showed that PHET can efectively prevent the decline in QoL after LC surgery.
- Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility TrialPublication . Machado, Pedro; Pimenta, Sara; Garcia, Ana Luís; Nogueira, Tiago; Silva, Sónia; Oliveiros, Bárbara; Martins, Raul A.; Cruz, JoanaBackground: Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. Methods: We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4–5 weeks after surgery. Results: Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, −1.5; 95% CI, from −2.1 to −0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. Conclusion: A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies.