human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Physical activity ( PA )  improves fatigue and quality of life ( QOL ) in cancer survivors . Our aim was to assess whether a 2-month PA intervention  improves fatigue and QOL for people with advanced lung cancer . Methods Participants with advanced lung cancer , Eastern Cooperative Oncology Group performance status ( PS ) ≤2 , > 6 months life expectancy , and ability to complete six-min walk test , were stratified ( disease stage , PS 0 - 1 versus 2 , centre ) and r and omized ( 1:1 ) in an open-label study to usual care ( UC ) ( nutrition and PA education material s ) or experimental intervention ( EX ) : UC plus 2-month supervised weekly PA and behaviour change sessions . Assessment s occurred at baseline , 2 , 4 , and 6 months . The primary endpoint was fatigue [ Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) question naire ] at 2 months . The study was design ed to detect a difference in mean FACT-F subscale score of 6 . Analysis was intention-to-treat using linear mixed models . Results We recruited 112 patients : 56 ( 50.4 % ) were r and omized to EX , 55(49.5 % ) to UC ; 1 ineligible . Male 55 % ; median age 64 years ( 34 - 80 ) ; 106 ( 96 % ) non-small cell lung cancer ; 106 ( 95.5 % ) stage IV . At 2 , 4 and 6 months , 90 , 73 and 62 participants were assessed , respectively , with no difference in attrition between groups . There were no significant differences in fatigue between the groups at 2 , 4 or 6 months : mean scores at 2 months EX 37.5 , UC 36.4 ( difference 1.2 , 95 % CI - 3.5 , 5.8 , P = 0.62 ) . There were no significant differences in QOL , symptoms , physical or functional status , or survival . Conclusions Adherence to the intervention was good but the intervention group did not increase their PA enough compared to the control group , and no difference was seen in fatigue or QOL . Trial Registration Australian New Zeal and Clinical Trials Registry No. ACTRN12609000971235 OBJECTIVES The goal of this study was to assess the impact of a preoperative 1-week , systematic , high-intensity inpatient exercise regimen on patients with lung cancer who had risk factors for postoperative pulmonary complications ( PPCs ) . METHODS We conducted a r and omized controlled trial with 101 subjects of a preoperative , 7-day systematic , integrated , high-intensity pulmonary exercise regimen .  The control group received st and ard preoperative care . We analysed the occurrence of PPCs in both groups as the primary outcome ; other outcomes included changes in blood gas , quality of life , peak expiratory flow rate , the 6-min walk distance and others . RESULTS The 6-min walk distance showed an increase of 22.9 ± 25.9 m in the intervention group compared with 4.2 ± 9.2 m in the control group , giving a between-group difference of 18.7 m ( 95 % confidence interval : 8.8 - 28.6 ; P < 0.001 ) ; the peak expiratory flow increased by 25.2 ± 24.6 l/min , compared with 4.2 ± 7.7 l/min ( between-group difference : 21.0 m , 95 % confidence interval : 7.2 - 34.8 ; P = 0.003 ) . The intervention group had a shorter average total ( 15.6 ± 3.6 vs 17.7 ± 5.3 days , P = 0.023 ) and postoperative length of stay ( 6.1 ± 3.0 vs 8.7 ± 4.6 days , P = 0.001 ) than the control group ; the incidence of PPCs ( 9.8 % , 5/51 vs 28.0 % , 14/50 , P = 0.019 ) was significantly lower . A multivariable analysis of the risk of PPCs identified short-term rehabilitation intervention to be an independent risk factor ( odds ratio = 0.156 , 95 % confidence interval : 0.037 - 0.649 , P = 0.011 ) . CONCLUSIONS The study results suggested that a systematic , high-intensity pulmonary exercise programme was a practical strategy when performed preoperatively in patients with lung cancer with risk factors for PPCs . CLINICAL TRIAL REGISTRATION ChiCTR-IOR-16008109 OBJECTIVES Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer . This r and omized trial evaluates the impact of adding rehabilitation ( Rehab ) with high-intensity interval training ( HIIT ) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome . METHODS Patients with operable lung cancer were r and omly assigned to  usual care ( UC , n = 77 ) or to intervention group ( Rehab  , n = 74 ) that entailed HIIT that was implemented only preoperatively .  Cardiopulmonary exercise testing ( CPET ) and pulmonary functional tests ( PFTs ) including forced vital capacity ( FVC ) , forced expiratory volume ( FEV 1 ) and carbon monoxide transfer factor ( KCO ) were performed before and 1 year after surgery . RESULTS During the preoperative waiting time ( median 25 days ) , Rehab patients participated to a median of 8 HIIT sessions ( interquartile [ IQ ] 25 - 75 % , 7 - 10 ) . At 1 year follow-up , 91 % UC patients and 93 % Rehab patients were still alive ( P = 0.506 ) . Pulmonary functional changes were non-significant and comparable in both groups ( FEV 1 mean -7.5 % , 95 % CI , -3.6 to -12.9 and in KCO mean 5.8 % 95 % CI 0.8 - 11.8 ) Compared with preoperative CPET results , both groups demonstrated similar reduction in peak oxygen uptake ( mean -12.2 % 95 % CI -4.8 to -18.2 ) and in peak work rate ( mean -11.1 % 95 % CI -4.2 to -17.4 ) . CONCLUSIONS Short-term preoperative rehabilitation with HIIT does not improve pulmonary function and aerobic capacity measured at 1 year after lung cancer resection . TRIAL REGISTRY Clinical Trials.gov ; No. NCT01258478 ; www . clinical trials.gov BACKGROUND The impact of short-term preoperative pulmonary rehabilitation on exercise capacity of patients with chronic obstructive pulmonary disease undergoing lobectomy for non-small cell lung cancer is evaluated . METHODS A prospect i ve observational study was design ed . Inclusion criteria consisted of an indication to lung resection because of a clinical stage I or II non-small cell lung cancer and a chronic obstructive disease on preoperative pulmonary function test . In such conditions , maximal oxygen consumption by a cardio-pulmonary exercise test was evaluated ; when this result ed as being < or = 15 ml/kg/min a pulmonary rehabilitation programme lasting 4 weeks was considered . Twelve patients fulfilled inclusion criteria , completed the preoperative rehabilitation programme and underwent a new functional evaluation prior to surgery . The postoperative record of these patients was collected . RESULTS On completion of pulmonary rehabilitation , the resting pulmonary function test and diffuse lung capacity of patients was unchanged , whereas the exercise performance was found to have significantly improved ; the mean increase in maximal oxygen consumption proved to be at 2.8 ml/kg/min ( p<0.01 ) . Eleven patients underwent lobectomy ; no postoperative mortality was noted and mean hospital stay was 17 days . Postoperative pulmonary complication was recorded in 8 patients . CONCLUSIONS Short-term preoperative pulmonary rehabilitation could improve the exercise capacity of patients with chronic obstructive pulmonary disease who are c and i date s for lung resection for non-small cell lung cancer Abstract Background . Patients with lung cancer are often burdened by dyspnoea , fatigue , decreased physical ability and loss of weight . Earlier studies of physical exercise of patients with COPD have shown promising results . The aim of this study was to investigate , if a well-documented COPD rehabilitation protocol can improve physical fitness and quality of life ( QoL ) in patients with lung cancer . Material and methods . Forty-five patients , with a minimum walking distance of 50 meters , absence of cognitive deficits or severe heart disease and motivated for physical training were invited to an exercise intervention .  The intervention consisted of seven weeks of twice weekly training , focusing on walking training , circuit training , h and ling of dyspnoea and instructions in daily diary-based training at home . Prior to , and after the intervention , Incremental- and Endurance Shuttle Walk Test ( ISWT and ESWT ) were performed , and pulmonary function as well as self-reported QoL ( EORTC-QLQ-C30 and LC13 ) were measured . Results . Fourteen subjects dropped out before commencement of the intervention . Seven were excluded after physiotherapeutic evaluation . Of the remaining 24 , three were excluded because of insufficient attendance ( < 65 % of scheduled exercise sessions ) thus 21 patients completed the intervention . For 17 patients with complete pre- and post intervention data , ISWT increased 9 % ( −77 to 39 % ) ( median and range ) ( p = 0.021 ) , while ESWT increased 109 % ( −70 to 432 % ) ( p = 0.002 ) . Twelve of 17 improved in ISWT , while 15 improved in ESWT . No changes in pulmonary function and improvements in QoL were observed . Conclusion . Patients with pulmonary cancer can achieve significant improvements in physical fitness measured with ISWT and ESWT after completion of the intervention program . No changes in pulmonary function and QoL were observed . In addition , we found that a large number of patients dropped out before intervention and that the patients , who succeeded , often discontinued training at home Background The purpose of the PROLUCA study is to investigate the efficacy of preoperative and early postoperative rehabilitation in a non-hospital setting in patients with operable lung cancer with special focus on exercise . Methods Using a 2x2 factorial design with continuous effect endpoint ( Maximal Oxygen Uptake ( VO2peak ) ) , 380 patients with non-small cell lung cancer ( NSCLC ) stage I-IIIa referred for surgical resection will be r and omly assigned to one of four groups : ( 1 ) preoperative and early postoperative rehabilitation ( starting two weeks after surgery ) ; ( 2 ) preoperative and late postoperative rehabilitation ( starting six weeks after surgery ) ; ( 3 ) early postoperative rehabilitation alone ; ( 4 ) today ’s st and ard care which is postoperative rehabilitation initiated six weeks after surgery . The preoperative rehabilitation program consists of an individually design ed , 30-minute home-based exercise program performed daily . The postoperative rehabilitation program consists of a supervised group exercise program comprising cardiovascular and resistance training two-hour weekly for 12 weeks combined with individual counseling . The primary study endpoint is VO2peak and secondary endpoints include : Six-minute walk distance ( 6MWD ) , one-repetition-maximum ( 1RM ) , pulmonary function , patient-reported outcomes ( PROs ) on health-related quality of life ( HRQoL ) , symptoms and side effects of the cancer disease and the treatment of the disease , anxiety , depression , wellbeing , lifestyle , hospitalization time , sick leave , work status , postoperative complications ( up to 30 days after surgery ) and survival . Endpoints will be assessed at baseline , the day before surgery , pre-intervention , post-intervention , six months after surgery and one year after surgery . Discussion The results of the PROLUCA study may potentially contribute to the identification of the optimal perioperative rehabilitation for operable lung cancer patients focusing on exercise initiated immediately after diagnosis and rehabilitation shortly after surgery . Trial Registration Purpose This r and omized controlled trial tested the effects of a specially design ed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy . Methods Between August 2010 and December 2011 , 46 patients were r and omized into two groups receiving either conventional physiotherapy or special physiotherapeutic training . The Barthel Index served as primary endpoint . The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( EORTC QLQ C-30/LC-13 ) question naire , the 6-Minute Walk Test ( 6MWT ) , stair walking , the Modified Borg Scale , and muscle strength . Nonparametrical data were analyzed with the Wilcoxon and Mann – Whitney U test . For parametric , data student t tests were used . A p value of ≤.05 was accepted . Results Twenty-nine patients completed the trial ( Intervention group ( IG ) , n = 18 ; control group ( CG ) , n = 11 ) . Significant differences were detectable in the Barthel Index ( IGmean = 92.08 ; CGmean = 81.67 ; p = .041 ) , in single scores of the EORTC QLQ C-30/LC-13 question naire ( physical functioning , 
    Output:
    
agent
For the functional capacity and medical care parameters , preoperative combined aerobic , resistance , and inspiratory muscle training was shown to be effective if comprising one to four weeks , performing 1 - 3 sessions per week , with moderate intensity ( 50 % for endurance capacity ) .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Physical activity ( PA )  improves fatigue and quality of life ( QOL ) in cancer survivors . Our aim was to assess whether a 2-month PA intervention  improves fatigue and QOL for people with advanced lung cancer . Methods Participants with advanced lung cancer , Eastern Cooperative Oncology Group performance status ( PS ) ≤2 , > 6 months life expectancy , and ability to complete six-min walk test , were stratified ( disease stage , PS 0 - 1 versus 2 , centre ) and r and omized ( 1:1 ) in an open-label study to usual care ( UC ) ( nutrition and PA education material s ) or experimental intervention ( EX ) : UC plus 2-month supervised weekly PA and behaviour change sessions . Assessment s occurred at baseline , 2 , 4 , and 6 months . The primary endpoint was fatigue [ Functional Assessment of Cancer Therapy-Fatigue ( FACT-F ) question naire ] at 2 months . The study was design ed to detect a difference in mean FACT-F subscale score of 6 . Analysis was intention-to-treat using linear mixed models . Results We recruited 112 patients : 56 ( 50.4 % ) were r and omized to EX , 55(49.5 % ) to UC ; 1 ineligible . Male 55 % ; median age 64 years ( 34 - 80 ) ; 106 ( 96 % ) non-small cell lung cancer ; 106 ( 95.5 % ) stage IV . At 2 , 4 and 6 months , 90 , 73 and 62 participants were assessed , respectively , with no difference in attrition between groups . There were no significant differences in fatigue between the groups at 2 , 4 or 6 months : mean scores at 2 months EX 37.5 , UC 36.4 ( difference 1.2 , 95 % CI - 3.5 , 5.8 , P = 0.62 ) . There were no significant differences in QOL , symptoms , physical or functional status , or survival . Conclusions Adherence to the intervention was good but the intervention group did not increase their PA enough compared to the control group , and no difference was seen in fatigue or QOL . Trial Registration Australian New Zeal and Clinical Trials Registry No. ACTRN12609000971235 OBJECTIVES The goal of this study was to assess the impact of a preoperative 1-week , systematic , high-intensity inpatient exercise regimen on patients with lung cancer who had risk factors for postoperative pulmonary complications ( PPCs ) . METHODS We conducted a r and omized controlled trial with 101 subjects of a preoperative , 7-day systematic , integrated , high-intensity pulmonary exercise regimen .  The control group received st and ard preoperative care . We analysed the occurrence of PPCs in both groups as the primary outcome ; other outcomes included changes in blood gas , quality of life , peak expiratory flow rate , the 6-min walk distance and others . RESULTS The 6-min walk distance showed an increase of 22.9 ± 25.9 m in the intervention group compared with 4.2 ± 9.2 m in the control group , giving a between-group difference of 18.7 m ( 95 % confidence interval : 8.8 - 28.6 ; P < 0.001 ) ; the peak expiratory flow increased by 25.2 ± 24.6 l/min , compared with 4.2 ± 7.7 l/min ( between-group difference : 21.0 m , 95 % confidence interval : 7.2 - 34.8 ; P = 0.003 ) . The intervention group had a shorter average total ( 15.6 ± 3.6 vs 17.7 ± 5.3 days , P = 0.023 ) and postoperative length of stay ( 6.1 ± 3.0 vs 8.7 ± 4.6 days , P = 0.001 ) than the control group ; the incidence of PPCs ( 9.8 % , 5/51 vs 28.0 % , 14/50 , P = 0.019 ) was significantly lower . A multivariable analysis of the risk of PPCs identified short-term rehabilitation intervention to be an independent risk factor ( odds ratio = 0.156 , 95 % confidence interval : 0.037 - 0.649 , P = 0.011 ) . CONCLUSIONS The study results suggested that a systematic , high-intensity pulmonary exercise programme was a practical strategy when performed preoperatively in patients with lung cancer with risk factors for PPCs . CLINICAL TRIAL REGISTRATION ChiCTR-IOR-16008109 OBJECTIVES Poor aerobic fitness is a potential modifiable risk factor for long-term survival and quality of life in patients with lung cancer . This r and omized trial evaluates the impact of adding rehabilitation ( Rehab ) with high-intensity interval training ( HIIT ) before lung cancer surgery to enhance cardiorespiratory fitness and improve long-term postoperative outcome . METHODS Patients with operable lung cancer were r and omly assigned to  usual care ( UC , n = 77 ) or to intervention group ( Rehab  , n = 74 ) that entailed HIIT that was implemented only preoperatively .  Cardiopulmonary exercise testing ( CPET ) and pulmonary functional tests ( PFTs ) including forced vital capacity ( FVC ) , forced expiratory volume ( FEV 1 ) and carbon monoxide transfer factor ( KCO ) were performed before and 1 year after surgery . RESULTS During the preoperative waiting time ( median 25 days ) , Rehab patients participated to a median of 8 HIIT sessions ( interquartile [ IQ ] 25 - 75 % , 7 - 10 ) . At 1 year follow-up , 91 % UC patients and 93 % Rehab patients were still alive ( P = 0.506 ) . Pulmonary functional changes were non-significant and comparable in both groups ( FEV 1 mean -7.5 % , 95 % CI , -3.6 to -12.9 and in KCO mean 5.8 % 95 % CI 0.8 - 11.8 ) Compared with preoperative CPET results , both groups demonstrated similar reduction in peak oxygen uptake ( mean -12.2 % 95 % CI -4.8 to -18.2 ) and in peak work rate ( mean -11.1 % 95 % CI -4.2 to -17.4 ) . CONCLUSIONS Short-term preoperative rehabilitation with HIIT does not improve pulmonary function and aerobic capacity measured at 1 year after lung cancer resection . TRIAL REGISTRY Clinical Trials.gov ; No. NCT01258478 ; www . clinical trials.gov BACKGROUND The impact of short-term preoperative pulmonary rehabilitation on exercise capacity of patients with chronic obstructive pulmonary disease undergoing lobectomy for non-small cell lung cancer is evaluated . METHODS A prospect i ve observational study was design ed . Inclusion criteria consisted of an indication to lung resection because of a clinical stage I or II non-small cell lung cancer and a chronic obstructive disease on preoperative pulmonary function test . In such conditions , maximal oxygen consumption by a cardio-pulmonary exercise test was evaluated ; when this result ed as being < or = 15 ml/kg/min a pulmonary rehabilitation programme lasting 4 weeks was considered . Twelve patients fulfilled inclusion criteria , completed the preoperative rehabilitation programme and underwent a new functional evaluation prior to surgery . The postoperative record of these patients was collected . RESULTS On completion of pulmonary rehabilitation , the resting pulmonary function test and diffuse lung capacity of patients was unchanged , whereas the exercise performance was found to have significantly improved ; the mean increase in maximal oxygen consumption proved to be at 2.8 ml/kg/min ( p<0.01 ) . Eleven patients underwent lobectomy ; no postoperative mortality was noted and mean hospital stay was 17 days . Postoperative pulmonary complication was recorded in 8 patients . CONCLUSIONS Short-term preoperative pulmonary rehabilitation could improve the exercise capacity of patients with chronic obstructive pulmonary disease who are c and i date s for lung resection for non-small cell lung cancer Abstract Background . Patients with lung cancer are often burdened by dyspnoea , fatigue , decreased physical ability and loss of weight . Earlier studies of physical exercise of patients with COPD have shown promising results . The aim of this study was to investigate , if a well-documented COPD rehabilitation protocol can improve physical fitness and quality of life ( QoL ) in patients with lung cancer . Material and methods . Forty-five patients , with a minimum walking distance of 50 meters , absence of cognitive deficits or severe heart disease and motivated for physical training were invited to an exercise intervention .  The intervention consisted of seven weeks of twice weekly training , focusing on walking training , circuit training , h and ling of dyspnoea and instructions in daily diary-based training at home . Prior to , and after the intervention , Incremental- and Endurance Shuttle Walk Test ( ISWT and ESWT ) were performed , and pulmonary function as well as self-reported QoL ( EORTC-QLQ-C30 and LC13 ) were measured . Results . Fourteen subjects dropped out before commencement of the intervention . Seven were excluded after physiotherapeutic evaluation . Of the remaining 24 , three were excluded because of insufficient attendance ( < 65 % of scheduled exercise sessions ) thus 21 patients completed the intervention . For 17 patients with complete pre- and post intervention data , ISWT increased 9 % ( −77 to 39 % ) ( median and range ) ( p = 0.021 ) , while ESWT increased 109 % ( −70 to 432 % ) ( p = 0.002 ) . Twelve of 17 improved in ISWT , while 15 improved in ESWT . No changes in pulmonary function and improvements in QoL were observed . Conclusion . Patients with pulmonary cancer can achieve significant improvements in physical fitness measured with ISWT and ESWT after completion of the intervention program . No changes in pulmonary function and QoL were observed . In addition , we found that a large number of patients dropped out before intervention and that the patients , who succeeded , often discontinued training at home Background The purpose of the PROLUCA study is to investigate the efficacy of preoperative and early postoperative rehabilitation in a non-hospital setting in patients with operable lung cancer with special focus on exercise . Methods Using a 2x2 factorial design with continuous effect endpoint ( Maximal Oxygen Uptake ( VO2peak ) ) , 380 patients with non-small cell lung cancer ( NSCLC ) stage I-IIIa referred for surgical resection will be r and omly assigned to one of four groups : ( 1 ) preoperative and early postoperative rehabilitation ( starting two weeks after surgery ) ; ( 2 ) preoperative and late postoperative rehabilitation ( starting six weeks after surgery ) ; ( 3 ) early postoperative rehabilitation alone ; ( 4 ) today ’s st and ard care which is postoperative rehabilitation initiated six weeks after surgery . The preoperative rehabilitation program consists of an individually design ed , 30-minute home-based exercise program performed daily . The postoperative rehabilitation program consists of a supervised group exercise program comprising cardiovascular and resistance training two-hour weekly for 12 weeks combined with individual counseling . The primary study endpoint is VO2peak and secondary endpoints include : Six-minute walk distance ( 6MWD ) , one-repetition-maximum ( 1RM ) , pulmonary function , patient-reported outcomes ( PROs ) on health-related quality of life ( HRQoL ) , symptoms and side effects of the cancer disease and the treatment of the disease , anxiety , depression , wellbeing , lifestyle , hospitalization time , sick leave , work status , postoperative complications ( up to 30 days after surgery ) and survival . Endpoints will be assessed at baseline , the day before surgery , pre-intervention , post-intervention , six months after surgery and one year after surgery . Discussion The results of the PROLUCA study may potentially contribute to the identification of the optimal perioperative rehabilitation for operable lung cancer patients focusing on exercise initiated immediately after diagnosis and rehabilitation shortly after surgery . Trial Registration Purpose This r and omized controlled trial tested the effects of a specially design ed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy . Methods Between August 2010 and December 2011 , 46 patients were r and omized into two groups receiving either conventional physiotherapy or special physiotherapeutic training . The Barthel Index served as primary endpoint . The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( EORTC QLQ C-30/LC-13 ) question naire , the 6-Minute Walk Test ( 6MWT ) , stair walking , the Modified Borg Scale , and muscle strength . Nonparametrical data were analyzed with the Wilcoxon and Mann – Whitney U test . For parametric , data student t tests were used . A p value of ≤.05 was accepted . Results Twenty-nine patients completed the trial ( Intervention group ( IG ) , n = 18 ; control group ( CG ) , n = 11 ) . Significant differences were detectable in the Barthel Index ( IGmean = 92.08 ; CGmean = 81.67 ; p = .041 ) , in single scores of the EORTC QLQ C-30/LC-13 question naire ( physical functioning , 
    Output:
    