{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T22:06:05Z","timestamp":1768514765602,"version":"3.49.0"},"reference-count":85,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Portuguese Foundation for Science and Technology","award":["UIDB\/05704\/2020"],"award-info":[{"award-number":["UIDB\/05704\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: 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\u20135 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, \u22121.5; 95% CI, from \u22122.1 to \u22120.9; 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.<\/jats:p>","DOI":"10.3390\/jcm12082971","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T02:01:11Z","timestamp":1681956071000},"page":"2971","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1147-2778","authenticated-orcid":false,"given":"Pedro","family":"Machado","sequence":"first","affiliation":[{"name":"Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal"},{"name":"Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID\/PTD\/04213\/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal"},{"name":"Physioclem, Physical Therapy Clinics, 2460-042 Alcoba\u00e7a, Portugal"}]},{"given":"Sara","family":"Pimenta","sequence":"additional","affiliation":[{"name":"Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal"}]},{"given":"Ana Lu\u00eds","family":"Garcia","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal"}]},{"given":"Tiago","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Unit, Portuguese Oncology Institute of Coimbra, 3000-075 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3655-5580","authenticated-orcid":false,"given":"S\u00f3nia","family":"Silva","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Leiria Hospital Center, 2410-197 Leiria, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7836-8161","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Oliveiros","sequence":"additional","affiliation":[{"name":"Laboratory of Biostatistics and Medical Informatics (LBIM), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal"},{"name":"Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal"},{"name":"Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, 3000-548 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-4560","authenticated-orcid":false,"given":"Raul A.","family":"Martins","sequence":"additional","affiliation":[{"name":"Univ Coimbra, Research Unit for Sport and Physical Activity (CIDAF, UID\/PTD\/04213\/2019), Faculty of Sport Sciences and Physical Education, 3040-248 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4911-4469","authenticated-orcid":false,"given":"Joana","family":"Cruz","sequence":"additional","affiliation":[{"name":"Center for Innovative Care and Health Technology (ciTechCare), School of Health Sciences of the Polytechnic of Leiria (ESSLei), 2411-901 Leiria, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bugge, A.S., Kongerud, J.S., Valberg, M., Solberg, S.K., Brustugun, O.T., and Lund, M.B. (2017). Long-term survival after surgical resection for non-small cell lung cancer. Eur. Respir. J., 50.","DOI":"10.1183\/1393003.congress-2017.PA4292"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1245\/s10434-019-08090-4","article-title":"Impact on Health-Related Quality of Life of Video-Assisted Thoracoscopic Surgery for Lung Cancer","volume":"27","author":"Avery","year":"2020","journal-title":"Ann. Surg. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1513\/AnnalsATS.202001-029OC","article-title":"Longitudinal Health-related Quality of Life among Individuals Considering Treatment for Stage i Non-Small-Cell Lung Cancer","volume":"17","author":"Nugent","year":"2020","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1016\/j.athoracsur.2020.05.080","article-title":"Health-Related Quality of Life After Lobectomy for Lung Cancer: Conceptual Framework and Measurement","volume":"110","author":"Brown","year":"2020","journal-title":"Ann. Thorac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1136\/thx.2009.123083","article-title":"Postoperative pulmonary complications following thoracic surgery: Are there any modifiable risk factors?","volume":"65","author":"Agostini","year":"2010","journal-title":"Thorax"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/thoraxjnl-2015-207697","article-title":"Long-term impact of developing a postoperative pulmonary complication after lung surgery","volume":"71","author":"Lugg","year":"2016","journal-title":"Thorax"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/S1470-2045(20)30675-6","article-title":"Global demand for cancer surgery and an estimate of the optimal surgical and anaesthesia workforce between 2018 and 2040: A population-based modelling study","volume":"22","author":"Perera","year":"2021","journal-title":"Lancet. Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1080\/0284186X.2016.1266081","article-title":"Promoting a culture of prehabilitation for the surgical cancer patient","volume":"56","author":"Carli","year":"2017","journal-title":"Acta Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1111\/anae.14177","article-title":"Clinical guideline and recommendations on pre-operative exercise training in patients awaiting major non-cardiac surgery","volume":"73","author":"Tew","year":"2018","journal-title":"Anaesthesia"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.bpa.2021.01.001","article-title":"Prehabilitation before surgery: Is it for all patients?","volume":"35","author":"West","year":"2021","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s00520-013-2002-5","article-title":"Physical activity preferences of early-stage lung cancer survivors","volume":"22","author":"Philip","year":"2014","journal-title":"Support Care Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cavalheri, V., and Granger, C. (2017). Preoperative exercise training for patients with non-small cell lung cancer. Cochrane Database Syst. Rev., 2017.","DOI":"10.1002\/14651858.CD012020.pub2"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Rosero, I.D., Ram\u00edrez-V\u00e9lez, R., Lucia, A., Mart\u00ednez-Velilla, N., Santos-Lozano, A., Valenzuela, P.L., Morilla, I., and Izquierdo, M. (2019). Systematic review and meta-analysis of randomized, controlled trials on preoperative physical exercise interventions in patients with non-small-cell lung cancer. Cancers, 11.","DOI":"10.3390\/cancers11070944"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1136\/bjsports-2017-098032","article-title":"Preoperative exercise halves the postoperative complication rate in patients with lung cancer: A systematic review of the effect of exercise on complications, length of stay and quality of life in patients with cancer","volume":"52","author":"Steffens","year":"2018","journal-title":"Br. J. Sport. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/ejcts\/ezy301","article-title":"Guidelines for enhanced recovery after lung surgery: Recommendations of the Enhanced Recovery After Surgery (ERAS\u00ae) Society and the European Society of Thoracic Surgeons (ESTS)","volume":"55","author":"Batchelor","year":"2019","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1007\/s00520-018-4109-1","article-title":"Maximizing patient adherence to prehabilitation: What do the patients say?","volume":"26","author":"Ferreira","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s00520-020-05547-1","article-title":"Patient acceptance of prehabilitation for major surgery: An exploratory survey","volume":"29","author":"Waterland","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1007\/s00520-017-3952-9","article-title":"Factors influencing non-participation in an exercise program and attitudes towards physical activity amongst cancer survivors","volume":"26","author":"Hardcastle","year":"2018","journal-title":"Support Care Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1046\/j.1523-5394.2002.104003.x","article-title":"Exercise counseling and programming preferences of cancer survivors","volume":"10","author":"Jones","year":"2002","journal-title":"Cancer Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1177\/0269215516684179","article-title":"Preoperative exercise training prevents functional decline after lung resection surgery: A randomized, single-blind controlled trial","volume":"31","year":"2017","journal-title":"Clin. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Goldsmith, I., Chesterfield-Thomas, G., and Toghill, H. (2020). Pre-treatment optimization with pulmonary rehabilitation in lung cancer: Making the inoperable patients operable. EClinicalMedicine, 31.","DOI":"10.1016\/j.eclinm.2020.100663"},{"key":"ref_23","first-page":"323","article-title":"Short-Term Preoperative High-Intensity Interval Training in Patients Awaiting Lung Cancer Surgery: A Randomized Controlled Trial","volume":"12","author":"Licker","year":"2017","journal-title":"J. Thorac. Oncol. Off. Publ. Int. Assoc. Study Lung Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"712","DOI":"10.2340\/16501977-2592","article-title":"Preoperative high-intensity interval training is effective and safe in deconditioned patients with lung cancer: A randomized clinical trial","volume":"51","author":"Bhatia","year":"2019","journal-title":"J. Rehabil. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.critrevonc.2017.03.031","article-title":"Effects of prehabilitation and rehabilitation including a home-based component on physical fitness, adherence, treatment tolerance, and recovery in patients with non-small cell lung cancer: A systematic review","volume":"114","author":"Driessen","year":"2017","journal-title":"Crit. Rev. Oncol.\/Hematol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1155\/2013\/291059","article-title":"Feasibility and effectiveness of a home-based exercise training program before lung resection surgery","volume":"20","author":"Coats","year":"2013","journal-title":"Can. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1136\/thoraxjnl-2017-211395","article-title":"Association between age, deprivation and specific comorbid conditions and the receipt of major surgery in patients with non-small cell lung cancer in England: A population-based study","volume":"74","author":"Belot","year":"2019","journal-title":"Thorax"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Eldridge, S.M., Chan, C.L., Campbell, M.J., Bond, C.M., Hopewell, S., Thabane, L., Lancaster, G.A., Altman, D., Bretz, F., and Campbell, M. (2016). CONSORT 2010 statement: Extension to randomised pilot and feasibility trials. BMJ, 355.","DOI":"10.1136\/bmj.i5239"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1161\/CIR.0b013e31829b5b44","article-title":"Exercise standards for testing and training: A scientific statement from the American Heart Association","volume":"128","author":"Fletcher","year":"2013","journal-title":"Circulation"},{"key":"ref_30","first-page":"829","article-title":"Development of comorbidity-adapted exercise protocols for patients with knee osteoarthritis","volume":"9","author":"Avezaat","year":"2014","journal-title":"Clin. Interv. Aging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2473","DOI":"10.1249\/MSS.0000000000000664","article-title":"Updating ACSM\u2019s Recommendations for Exercise Preparticipation Health Screening","volume":"47","author":"Riebe","year":"2015","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1136\/bjsports-2016-096651","article-title":"Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement","volume":"50","author":"Slade","year":"2016","journal-title":"Br. J. Sport. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"374","DOI":"10.3747\/co.22.2650","article-title":"Enablers and barriers in delivery of a cancer exercise program: The Canadian experience","volume":"22","author":"Petrella","year":"2015","journal-title":"Curr. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_35","unstructured":"Machado, P., Morgado, M., Raposo, J., Mendes, M., Ferreira, L.E., and Roque, A. (2021). OncoEnergy\u2014Manual de Exerc\u00edcio F\u00edsico para Pessoas com Cancro, Escola Superior de Sa\u00fade do Polit\u00e9cnico de Leiria."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/j.jsams.2019.05.003","article-title":"The Exercise and Sports Science Australia position statement: Exercise medicine in cancer management","volume":"22","author":"Hayes","year":"2019","journal-title":"J. Sci. Med. Sport"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1080\/13548506.2016.1139739","article-title":"Newly diagnosed lung cancer patients\u2019 preferences for and beliefs about physical activity prior to chemotherapy","volume":"21","author":"Karvinen","year":"2016","journal-title":"Psychol. Health Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3239","DOI":"10.1007\/s00520-015-2717-6","article-title":"Exercise preferences, levels and quality of life in lung cancer survivors","volume":"23","author":"Leach","year":"2015","journal-title":"Support. Care Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.exger.2018.08.006","article-title":"The sit-to-stand muscle power test: An easy, inexpensive and portable procedure to assess muscle power in older people","volume":"112","author":"Alcazar","year":"2018","journal-title":"Exp. Gerontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2821","DOI":"10.1002\/cncr.29406","article-title":"The effect, moderators, and mediators of resistance and aerobic exercise on health-related quality of life in older long-term survivors of prostate cancer","volume":"121","author":"Buffart","year":"2015","journal-title":"Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00421-012-2421-x","article-title":"Associations between Borg\u2019s rating of perceived exertion and physiological measures of exercise intensity","volume":"113","author":"Scherr","year":"2013","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1519\/JSC.0000000000001991","article-title":"Monitoring resistance exercise intensity using ratings of perceived exertion in previously untrained patients with prostate cancer undergoing androgen deprivation therapy","volume":"32","author":"Fairman","year":"2018","journal-title":"J. Strength Cond. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1139\/h11-078","article-title":"Borg\u2019s scales in strength training; from theory to practice in young and older adults","volume":"36","author":"Buckley","year":"2011","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s00421-002-0768-0","article-title":"Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females","volume":"89","author":"Pincivero","year":"2003","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_46","first-page":"130","article-title":"Assessment of Subjective Perceived Exertion at the Anaerobic Threshold with the Borg CR-10 Scale","volume":"10","author":"Moreno","year":"2011","journal-title":"J. Sport. Sci. Med."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Singh, B., Spence, R., Steele, M.L., Hayes, S., and Toohey, K. (2020). Exercise for Individuals with Lung Cancer: A Systematic Review and Meta-Analysis of Adverse Events, Feasibility, and Effectiveness. Semin. Oncol. Nurs., 36.","DOI":"10.1016\/j.soncn.2020.151076"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.apmr.2016.08.482","article-title":"What Adherence Measures Should Be Used in Trials of Home-Based Rehabilitation Interventions? A Systematic Review of the Validity, Reliability, and Acceptability of Measures","volume":"98","author":"Frost","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s40279-015-0454-0","article-title":"Training Monitoring for Resistance Exercise: Theory and Applications","volume":"46","author":"Scott","year":"2016","journal-title":"Sport. Med."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Sekhon, M., Cartwright, M., and Francis, J.J. (2017). Acceptability of healthcare interventions: An overview of reviews and development of a theoretical framework. BMC Health Serv. Res., 17.","DOI":"10.1186\/s12913-017-2031-8"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s40814-018-0326-0","article-title":"Pilot and feasibility studies in exercise, physical activity, or rehabilitation research","volume":"4","author":"Giangregorio","year":"2018","journal-title":"Pilot Feasibility Stud."},{"key":"ref_52","first-page":"1646","article-title":"Safety of exercise-based cardiac rehabilitation and exercise testing for cardiac patients in Japan: A nationwide survey","volume":"78","author":"Saito","year":"2014","journal-title":"Circ. J. Off. J. Jpn. Circ. Soc."},{"key":"ref_53","unstructured":"National Cancer Institute (2022, February 01). Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0; US Department of Health and Human Services, National Institutes of Health, Available online: https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_8.5x11.pdf."},{"key":"ref_54","unstructured":"Therapeutics Good Administration Department of Health and Ageing Australian Government (2006). The Australian Clinical Trial Handbook: A Simple, Practical Guide to the Conduct of Clinical Trials to International Standards of Good Clinical Practice (GCP) in the Australian Context."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1093\/jnci\/85.5.365","article-title":"The European organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology","volume":"85","author":"Aaronson","year":"1993","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1200\/JCO.1995.13.5.1249","article-title":"Test\/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire","volume":"13","author":"Hjermstad","year":"1995","journal-title":"J. Clin. Oncol."},{"key":"ref_57","first-page":"89","article-title":"Validation study of the portuguese version of the QLQ-C30-V.3","volume":"9","author":"Pinto","year":"2008","journal-title":"Psicol. Sa\u00fade Doen\u00e7as"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jclinepi.2015.08.007","article-title":"Replication and validation of higher order models demonstrated that a summary score for the EORTC QLQ-C30 is robust","volume":"69","author":"Giesinger","year":"2016","journal-title":"J. Clin. Epidemiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1136\/thx.47.12.1019","article-title":"Development of a shuttle walking test of disability in patients with chronic airways obstruction","volume":"47","author":"Singh","year":"1992","journal-title":"Thorax"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1183\/09031936.00150314","article-title":"An official European Respiratory Society\/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease","volume":"44","author":"Holland","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/S0363-5023(84)80146-X","article-title":"Reliability and validity of grip and pinch strength evaluations","volume":"9","author":"Mathiowetz","year":"1984","journal-title":"J. Hand Surg."},{"key":"ref_62","unstructured":"Fess, E. (1981). Clinical assessment recommendations. Am. Soc. Hand Ther., 6\u20138."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1139\/H08-122","article-title":"Precision and reliability of strength (Jamar vs. Biodex handgrip) and body composition (dual-energy X-ray absorptiometry vs. bioimpedance analysis) measurements in advanced cancer patients","volume":"33","author":"Trutschnigg","year":"2008","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2030","DOI":"10.1093\/gerona\/glab175","article-title":"Reliability and Minimal Detectable Change Values for Performance-Based Measures of Physical Functioning in the Canadian Longitudinal Study on Aging","volume":"76","author":"Beauchamp","year":"2021","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s40814-021-00770-x","article-title":"Determining sample size for progression criteria for pragmatic pilot RCTs: The hypothesis test strikes back!","volume":"7","author":"Lewis","year":"2021","journal-title":"Pilot Feasibility Stud."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/pst.185","article-title":"Sample size of 12 per group rule of thumb for a pilot study","volume":"4","author":"Julious","year":"2005","journal-title":"Pharm. Stat."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2055-5784-1-1","article-title":"Pilot and feasibility studies come of age!","volume":"1","author":"Lancaster","year":"2015","journal-title":"Pilot Feasibility Stud."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s40814-019-0493-7","article-title":"Should treatment effects be estimated in pilot and feasibility studies?","volume":"5","author":"Sim","year":"2019","journal-title":"Pilot Feasibility Stud."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/j..2002.384.doc.x","article-title":"Design and analysis of pilot studies: Recommendations for good practice","volume":"10","author":"Lancaster","year":"2004","journal-title":"J. Eval. Clin. Pract."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.lungcan.2022.03.018","article-title":"Minimally important differences of EORTC QLQ-C30 scales in patients with lung cancer or malignant pleural mesothelioma\u2014Interpretation guidance derived from two randomized EORTC trials","volume":"167","author":"Koller","year":"2022","journal-title":"Lung Cancer"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.apmr.2012.08.206","article-title":"Preoperative pulmonary rehabilitation versus chest physical therapy in patients undergoing lung cancer resection: A pilot randomized controlled trial","volume":"94","author":"Morano","year":"2013","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s12966-021-01116-9","article-title":"Factors influencing physical activity participation among people living with or beyond cancer: A systematic scoping review","volume":"18","author":"Elshahat","year":"2021","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1001\/jamaoncol.2015.2639","article-title":"Validity and Reliability of the US National Cancer Institute\u2019s Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)","volume":"1","author":"Dueck","year":"2015","journal-title":"JAMA Oncol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1002\/jcsm.12828","article-title":"Effects and tolerability of exercise therapy modality on cardiorespiratory fitness in lung cancer: A randomized controlled trial","volume":"12","author":"Scott","year":"2021","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1249\/MSS.0000000000001545","article-title":"Novel Methods for Reporting of Exercise Dose and Adherence: An Exploratory Analysis","volume":"50","author":"Nilsen","year":"2018","journal-title":"Med. Sci. Sport. Exerc."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jpainsymman.2010.05.017","article-title":"Fatigue and functional impairment in early-stage non-small cell lung cancer survivors","volume":"41","author":"Hung","year":"2011","journal-title":"J. Pain Symptom Manag."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jpainsymman.2014.06.003","article-title":"Symptom Prevalence in Lung and Colorectal Cancer Patients","volume":"49","author":"Walling","year":"2015","journal-title":"J. Pain Symptom Manag."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/ejcts\/ezaa245","article-title":"Poor preoperative quality of life predicts prolonged hospital stay after VATS lobectomy for lung cancer","volume":"59","author":"Pompili","year":"2021","journal-title":"Eur. J. Cardio-Thorac. Surg. Off. J. Eur. Assoc. Cardio-Thorac. Surg."},{"key":"ref_79","first-page":"526","article-title":"Poor preoperative patient-reported quality of life is associated with complications following pulmonary lobectomy for lung cancer","volume":"51","author":"Pompili","year":"2017","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Machado, P., Pimenta, S., Oliveiros, B., Ferreira, J.P., Martins, R.A., and Cruz, J. (2021). Effect of Exercise Training on Quality of Life after Colorectal and Lung Cancer Surgery: A Meta-Analysis. Cancers, 13.","DOI":"10.3390\/cancers13194975"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.jphys.2022.03.001","article-title":"The 6-minute stepper test and the sit-to-stand test predict complications after major pulmonary resection via minimally invasive surgery: A prospective inception cohort study","volume":"68","author":"Boujibar","year":"2022","journal-title":"J. Physiother."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1200\/JCO.2006.07.7230","article-title":"Quality of life and survival in the 2 years after surgery for non-small-cell lung cancer","volume":"26","author":"Kenny","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1016\/j.jtcvs.2007.06.025","article-title":"Long-term recovery of exercise capacity and pulmonary function after lobectomy","volume":"134","author":"Nagamatsu","year":"2007","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Edvardsen, E., Anderssen, S.A., Borchsenius, F., and Skj\u00f8nsberg, O.H. (2015). Reduction in cardiorespiratory fitness after lung resection is not related to the number of lung segments removed. BMJ Open Sport Exerc. Med., 1.","DOI":"10.1183\/13993003.congress-2015.PA4280"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1186\/s13063-016-1615-7","article-title":"Optimising the validity and completion of adherence diaries: A multiple case study and randomised crossover trial","volume":"17","author":"Frost","year":"2016","journal-title":"Trials"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/8\/2971\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:18:59Z","timestamp":1760123939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/8\/2971"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,19]]},"references-count":85,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcm12082971"],"URL":"https:\/\/doi.org\/10.3390\/jcm12082971","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,19]]}}}