Discussion
lung cancer, pain, non-cystic fibrosis bronchiectasis, trauma
LUNG CANCER, NON-CYSTIC FIBROSIS BRONCHIECTASIS
To our knowledge, the present trial is the first to directly compare two combined ACT programs comprising Acapella plus ACBT and EDP plus ACBT, both with one another and with the single-model ACBT program. The results support the hypothesis that preparing perioperative patients for surgical resection of lung cancer with the combined ACTs programs leads to a better functional capacity and lung function after pulmonary surgery compared with the single ACBT program; additionally, the combined ACT programs were safe and effective therapies for the rehabilitation of perioperative patients with lung cancer.Compared with ACBT, both combined ACT programs significantly improved the 6MWT distance over the 1-week and 1-month postoperative follow-up period. Our finding of short-term improvement in the 6MWT distance is consistent with that reported previously. One study observed a significant improvement in the functional capacity for patients with non-cystic fibrosis bronchiectasis following ACT combined with exercise training, with a mean change (95% CI) in 6MWD of 41 m (95% CI, 19–63) compared with the control group (All three groups in this study showed a reduction in FEV1% of predicted after surgery. In line with our findings, a previous study showed that lung function parameters did not return to baseline levels, possibly because of surgical trauma, wound-related pain, and indwelling of the chest tube [The improvement in FEV1% of predicted in the combined EDP plus ACBT group was significantly better than that in the other groups at both follow-up period. With longer-term follow-ups, an upward trend may persist in the EDP plus ACBT group, which can be explained by the timing of intervention delivery. The study has examined the main effects of group and time and interaction effects between group and time, and the findings of the primary analysis would not be altered. The results of this trial affirmed findings from a previous study, indicating that perioperative patients with lung cancer benefit from EDP plus ACBT with improved lung function [In this study, EDP plus ACBT favoured longer walking distances than did the other two therapies. In contrast, a previous study reported no significant difference in the 6MWT distance between breathing training using ACBT (n = 15) and that assisted by EDP plus ACBT (n = 15), which may have resulted from the small sample size [The incidence rate of PPCs has been estimated to be 15–59% in patients who have undergone lung cancer surgery, which is consistent with the results of this study [