Study strengths, limitations, and future directions
lung cancer, heterogenous, dyspnea
LUNG CANCER, EVENTS
Strengths include: 1) a contemporary sample of lung cancer survivors within 1–6 months following curative intent therapy; 2) evaluation of a novel targeted intervention to disrupt a vicious cycle of “dyspnea-inactivity”; 3) block randomization to ensure balance between groups in a heterogenous population; 4) high feasibility and acceptability; 5) monitoring of safety events that included emergency room visits/hospitalizations in both groups; and 6) telemedicine-based delivery with minimal equipment and interventionist training, enhancing scalability and geographic reach potential.Study limitations include participant adherence to IMT assessed by self-report, predisposing to social desirability and reporting bias. However, adherence measures completion was high, with step counts obtained by participants from Fitbit devices. Second, the m6MWT has not been evaluated in lung cancer, with responsiveness of the m6MWT distance is not known with certainty, precluding conclusions on feasibility. Nevertheless, functional exercise capacity is associated with HRQL [Future trials can consider baseline dyspnea and physical activity levels to reduce participant heterogeneity, investigation of biophysiological mechanisms relating dyspnea and IMT, incorporate additional components, possibly with novel randomized trial designs (e.g., multiphase optimization strategy, hybrid, adaptive, platform) to encourage uptake, completion, and clinical translation.