Effects and tolerability of exercise therapy modality on cardiorespiratory fitness in lung cancer: a randomized controlled trial
Bibliographic record
Abstract
Abstract Background Poor cardiorespiratory fitness (CRF) is a cardinal feature of post‐treatment primary lung cancer. The most effective exercise therapy regimen to improve CRF has not been determined. Methods In this parallel‐group factorial randomized controlled trial, lung cancer survivors with poor CRF (below age–sex sedentary values) were randomly allocated to receive 48 consecutive supervised sessions thrice weekly of (i) aerobic training (AT)—cycle ergometry at 55% to >95% of peak oxygen consumption (VO 2 peak); (ii) resistance training (RT)—lower and upper extremity exercises at 50–85% of maximal strength; (iii) combination training (CT)—AT plus RT; or (iv) stretching attention control (AC) for 16 weeks. The primary endpoint was change in CRF (VO 2 peak, mL O 2 ·kg −1 ·min −1 ). Secondary endpoints were body composition, muscle strength, patient‐reported outcomes, tolerability (relative dose intensity of exercise), and safety. Analysis of covariance determined change in primary and secondary endpoints from baseline to post‐intervention (Week 17) with adjustment for baseline values of the endpoint and other relevant clinical covariates. Results Ninety patients (65 ± 9 years; 66% female) were randomized (AT, n = 24; RT, n = 23; CT, n = 20; and AC, n = 23) of the planned n = 160. No serious adverse events were observed. For the overall cohort, the lost‐to‐follow‐up rate was 10%. Mean attendance was ≥75% in all groups. In intention‐to‐treat analysis, VO 2 peak increased 1.1 mL O 2 ·kg −1 ·min −1 [95% confidence interval (CI): 0.0, 2.2, P = 0.04] and 1.4 mL O 2 ·kg −1 ·min −1 (95% CI: 0.2, 2.5, P = 0.02) in AT and CT, respectively, compared with AC. There was no difference in VO 2 peak change between RT and AC (−0.1 mL O 2 ·kg −1 ·min −1 , 95% CI: −1.2, 1.0, P = 0.88). Favourable improvements in maximal strength and body composition were observed in RT and CT groups compared with AT and AC groups ( P s < 0.05). No between‐group changes were observed for any patient‐reported outcomes. Relative dose intensity of exercise was lower in RT and CT compared with AT ( P s < 0.05). Conclusions In the context of a smaller than planned sample size, AT and CT significantly improved VO 2 peak in lung cancer survivors; however, the tolerability‐to‐benefit ratio was superior for AT and hence may be the preferred modality to target impaired CRF in post‐treatment lung cancer survivors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".