Investigation of exercise capacity pulmonary functions and physical activity levels in lung cancer undergoing pneumonectomy

Pneumonectomy, surgical removal of the entire lung, is generally applied to centrally located or large sized tumors in non-small cell lung cancer. Limited studies have investigated the effects of anatomical and physiological consequences on cardiorespiratory functions after pneumonectomy. To compare pulmonary function (spirometry), functional exercise capacity (6 minute walking test (6-MWT), Pegboard and Ring test (6-PBRT)), respiratory muscle strength (mouth pressure device, MİP, MEP) and endurance (threshold loading test), peripheral muscle strength (dynamometer), physical activity level (metabolic holter), quality of life (European Organization for Research and Treatment of Cancer (EORTC QLQ-C30), fatigue (Fatigue Severity Scale (FSS)), dyspnea (MMRC scale) in patients and healthy was aimed. 14 patients and 17 healthy controls were compared. Patients' FEV1, FVC, PEF, FEF%25-75, 6-MWT distance, 6-PBRT number of rings, MIP, MEP; shoulder abductor and knee extensor muscle strength, respiratory muscle endurance and physical activity parameter scores were statistically significantly lower, FSS and MMRC dyspnea scale scores were higher, EORTC QLQ-C30 subscale scores were worse compared with controls (p<0.05). According to number of steps/day and MET, 78.6% and 100% of patients were sedentary, respectively. Pulmonary function is impaired in patients with lung cancer undergoing pneumonectomy, upper and lower extremity functional exercise capacity and physical activity levels are decreased. Inspiratory, expiratory and peripheral muscles are weakened, respiratory muscle endurance is decreased. Quality of life is impaired, dyspnea and fatigue perception are increased. Patients have to be evaluated at the earliest stage and included in cardiopulmonary rehabilitation programs in order to improve impairments. The effect of exercise training on the upper extremity functional exercise capacity should be investigated in patients. COVID-19 pandemic may have increased physical inactivity thus physical activity counseling is warranted.