{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:53:11Z","timestamp":1782492791458,"version":"3.54.5"},"reference-count":27,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020207","name":"Health Commission of Sichuan Province","doi-asserted-by":"publisher","award":["24LCYJZD08"],"award-info":[{"award-number":["24LCYJZD08"]}],"id":[{"id":"10.13039\/501100020207","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Sichuan Province Key Clinical Specialty Construction Project","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}]},{"name":"Scientific Research Project of Sichuan Medical Association","award":["S23102"],"award-info":[{"award-number":["S23102"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Walking, as a simple, low-cost and easily implemented form of exercise, offers multiple health advantages. The WalkLung trial aims to evaluate the efficacy of a home-based walking exercise and education intervention in promoting early functional recovery after lung cancer surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>\n                      WalkLung is a multicentre, parallel-group, randomised controlled trial conducted at three hospitals in China, with stratification by study centre. A total of 116 patients with postoperative lung cancer will be randomised in a 1:1 ratio to either the intervention group (home-based walking exercise and education for 4 weeks) or the control group (usual care). The primary outcome is the longitudinal walking difficulty score during the 4-week postdischarge, measured by the validated perioperative symptom assessment for lung surgery scale (0\u201310\u2009scale), assessed at discharge and weekly for 4 weeks. Secondary outcomes are the 6-min walk test, pulmonary function, complications, physical activity level, quality of life, social functioning, exercise adherence and adverse events. Long-term outcomes (up to 6 months) will be analysed and reported separately. All analyses will use an intention-to-treat approach, with outcome measures analysed as appropriate using generalised estimating equations for repeated measures, and t-tests or \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was obtained from the Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital (No. SCCHEC-02-2025-091) and all participating subcentres. Written informed consent will be obtained from all participants. The manuscript is based on protocol V.1.0 (2 January 2025). The study findings will be disseminated through peer-reviewed journal publications and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2500103081.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-112444","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T16:20:49Z","timestamp":1774282849000},"page":"e112444","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of home-based walking exercise and education on early functional recovery after lung cancer surgery: protocol for the WalkLung multicentre randomised controlled trial"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9182-3797","authenticated-orcid":false,"given":"Yadi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuyang","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puyang","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1311-515X","authenticated-orcid":false,"given":"Cheng","family":"Lei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Health Management Center, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Gui","sequence":"additional","affiliation":[{"name":"Central Sterile Supply Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Ya'an People's Hospital, Ya'an, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanmei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dequn","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanqiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3035-5633","authenticated-orcid":false,"given":"Xing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1283-3045","authenticated-orcid":false,"given":"Bo","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-3809","authenticated-orcid":false,"given":"Qiuling","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"},{"name":"College of Public Health, Chongqing Medical University, Chongqing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaokang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Zigong First People's Hospital, Zigong, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-1590","authenticated-orcid":false,"given":"Wei","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, Sichuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"2026062609363634000_16.3.e112444.1","doi-asserted-by":"publisher","DOI":"10.3322\/CAAC.21834"},{"key":"2026062609363634000_16.3.e112444.2","doi-asserted-by":"crossref","first-page":"4553","DOI":"10.1245\/s10434-023-13579-0","article-title":"Segmentectomy is the Surgical Procedure of Choice for Peripheral Early-Stage Non-small Cell Lung Cancer (Most Likely!)","volume":"30","author":"Brunelli","year":"2023","journal-title":"Ann Surg Oncol"},{"key":"2026062609363634000_16.3.e112444.3","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1200\/JCO.21.01344","article-title":"Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial","volume":"40","author":"Dai","year":"2022","journal-title":"J Clin Oncol"},{"key":"2026062609363634000_16.3.e112444.4","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.jtcvs.2015.05.057","article-title":"Symptom recovery after thoracic surgery: Measuring patient-reported outcomes with the MD Anderson Symptom Inventory","volume":"150","author":"Fagundes","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026062609363634000_16.3.e112444.5","doi-asserted-by":"crossref","first-page":"2607","DOI":"10.1245\/s10434-022-13065-z","article-title":"Symptom Trajectories Informing Patient Care After Lung Cancer Surgery: A Longitudinal Patient-Reported Outcome Study","volume":"30","author":"Tang","year":"2023","journal-title":"Ann Surg Oncol"},{"key":"2026062609363634000_16.3.e112444.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2011.01.006"},{"key":"2026062609363634000_16.3.e112444.7","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/HCR.0000000000000091","article-title":"Exercise-based oncology rehabilitation: leveraging the cardiac rehabilitation model","volume":"35","author":"Dittus","year":"2015","journal-title":"J Cardiopulm Rehabil Prev"},{"key":"2026062609363634000_16.3.e112444.8","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1001\/jamasurg.2025.0130","article-title":"Precision Exercise Effect on Fatigue and Function in Lung Cancer Surgery: A Randomized Clinical Trial","volume":"160","author":"Ulrich","year":"2025","journal-title":"JAMA Surg"},{"key":"2026062609363634000_16.3.e112444.9","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2024.34180","article-title":"Wearable Device\u2013Based Intervention for Promoting Patient Physical Activity After Lung Cancer Surgery","volume":"7","author":"Lee","year":"2024","journal-title":"JAMA Netw Open"},{"key":"2026062609363634000_16.3.e112444.10","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/60.11.1432"},{"key":"2026062609363634000_16.3.e112444.11","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.gerinurse.2021.12.021","article-title":"ABCDEF pulmonary rehabilitation program can improve the mid-term lung function of lung cancer patients after thoracoscopic surgery: A randomized controlled study","volume":"44","author":"Zou","year":"2022","journal-title":"Geriatr Nurs"},{"key":"2026062609363634000_16.3.e112444.12","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12062146","article-title":"Physiotherapy and Exercise Management of People Undergoing Surgery for Lung Cancer: A Survey of Current Practice across Australia and New Zealand","volume":"12","author":"Whish-Wilson","year":"2023","journal-title":"J Clin Med"},{"key":"2026062609363634000_16.3.e112444.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)00755-4"},{"key":"2026062609363634000_16.3.e112444.14","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.lungcan.2013.11.014","article-title":"Low physical activity levels and functional decline in individuals with lung cancer","volume":"83","author":"Granger","year":"2014","journal-title":"Lung Cancer (Auckl)"},{"key":"2026062609363634000_16.3.e112444.15","doi-asserted-by":"crossref","first-page":"e555","DOI":"10.1634\/theoncologist.2019-0463","article-title":"Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled?","volume":"25","author":"Avancini","year":"2020","journal-title":"Oncologist"},{"key":"2026062609363634000_16.3.e112444.16","doi-asserted-by":"crossref","DOI":"10.2196\/48355","article-title":"The Effect of Walking on Depressive and Anxiety Symptoms: Systematic Review and Meta-Analysis","volume":"10","author":"Xu","year":"2024","journal-title":"JMIR Public Health Surveill"},{"key":"2026062609363634000_16.3.e112444.17","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2014-094157"},{"key":"2026062609363634000_16.3.e112444.18","doi-asserted-by":"crossref","first-page":"3391","DOI":"10.1111\/jocn.12584","article-title":"Effects of an early postoperative walking exercise programme on health status in lung cancer patients recovering from lung lobectomy","volume":"23","author":"Chang","year":"2014","journal-title":"J Clin Nurs"},{"key":"2026062609363634000_16.3.e112444.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2020-037149","article-title":"Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial","volume":"10","author":"Pocovi","year":"2020","journal-title":"BMJ Open"},{"key":"2026062609363634000_16.3.e112444.20","doi-asserted-by":"crossref","first-page":"6591","DOI":"10.1097\/JS9.0000000000001855","article-title":"Electronic symptom monitoring after lung cancer surgery: establishing a core set of patient-reported outcomes for surgical oncology care in a longitudinal cohort study","volume":"110","author":"Yu","year":"2024","journal-title":"Int J Surg"},{"key":"2026062609363634000_16.3.e112444.21","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00150314"},{"key":"2026062609363634000_16.3.e112444.22","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"2026062609363634000_16.3.e112444.23","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jsams.2006.05.003","article-title":"Reliability and validity of the Chinese version of IPAQ (short, last 7 days)","volume":"10","author":"Macfarlane","year":"2007","journal-title":"J Sci Med Sport"},{"key":"2026062609363634000_16.3.e112444.24","doi-asserted-by":"crossref","unstructured":"Roudijk B , Ludwig K , Devlin N . EQ-5d-5l value set summaries. In: Devlin N , Roudijk B , Ludwig K , eds. Value Sets for EQ-5D-5L: A Compendium, Comparative Review & User Guide. Cham (CH): Springer, 2022: 55\u2013212.","DOI":"10.1007\/978-3-030-89289-0_4"},{"key":"2026062609363634000_16.3.e112444.25","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.adengl.2019.05.021","article-title":"Using the Common Terminology Criteria for Adverse Events (CTCAE \u2013 Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies","volume":"112","author":"Freites-Martinez","year":"2021","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas (English Edition)"},{"key":"2026062609363634000_16.3.e112444.26","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.athoracsur.2021.08.058","article-title":"Early Patient-Reported Outcomes After Uniportal vs Multiportal Thoracoscopic Lobectomy","volume":"114","author":"Dai","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"2026062609363634000_16.3.e112444.27","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf215"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-112444","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:41:41Z","timestamp":1782492101000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-112444"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,23]]},"published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1136\/bmjopen-2025-112444"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-112444","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]}}}