Effects Of Yoga Breathing Exercises Based On The ADOPT Mode On Lung Cancer Patients With Surgical Resection

Aim:The aim of this study was to investigate the impact of yoga breathing exercises based on the ADOPT mode as well as yoga breathing exercises on patients with nonsmall cell lung cancer undergoing thoracoscopic surgery.The outcomes included dyspnea,exercise capacity,anxiety,depression,quality of life(QOL),total in-hospital stay,postoperative pulmonary complications,postoperative indwelling time of thoracic drainage tube,and compliance.Methods:This prospective,single-center,parallel-group,assessor-blinded,three-arm randomized controlled trial was conducted from October 2019 to October 2020 in the Bethune First Hospital of Jilin University.A total of 108 lung cancer patients who met the inclusion criteria were randomly assigned to three groups based on the order of admission: the yoga breathing exercises based on the ADOPT mode group,the yoga breathing exercises group and the control group,36 in each group.Control group received usual care,while patients in the two intervention groups received yoga breathing exercises or yoga breathing exercises based on the ADOPT mode every day,from admission day to preoperative day 1 and from postoperative day 2 to discharge day,twice a day for about 20 minutes each time.The outcomes reported by patients were collected by face-to-face interviews at four time points: the day of admission(baseline),preoperative day 1,postoperative day 2,and hospital discharge.SPSS 24.0statistical software was used to analyze data.For all the outcomes,P < 0.05 was considered to be significant.Results:(1)Finally,the data of 104 patients were analyzed,and the demographic characteristics of the three groups were compared.There were no statistic differences in age(P=0.522),sex(P=0.471),body mass index(P=0.116),cancer stage(P=0.942)and lung function among the three groups,which was comparable.The baseline outcomes were collected on the day of admission,and it was found that there were no statistical difference among the three groups in dyspnea(P=0.845),exercise capacity(P=0.498),anxiety(P=0.520),depression(P=0.831),QOL functional scales(P=0.926),QOL symptom scales(P=0.949),global QOL(P=0.944),or QOL lung cancer scales(P=0.548).(2)On preoperative day 1,there was statistically significant difference in dyspnea(P=0.001),exercise capacity(P=0.001),anxiety(P=0.001),QOL functional scales(P=0.045),QOL symptom scales(P=0.028),global QOL(P=0.031)and QOL lung cancer scales(P=0.012)between the three groups.Compared with the control,the yoga breathing exercises based on the ADOPT mode group significantly improved dyspnea(P=0.001),exercise capacity(P=0.001),anxiety(P=0.001),QOL functional scales(P=0.039),QOL symptom scales(P=0.023),global QOL(P=0.028)and QOL lung cancer scales(P=0.009),and the differences were statistically significant;Compared with the control group,the yoga breathing exercises group significantly improved dyspnea(P=0.031)and anxiety(P=0.032),with statistical significance;Compared with the yoga breathing exercises group,the yoga breathing exercises based on the ADOPT mode group significantly improved exercise capacity(P=0.042),and the difference was statistically significant.(3)On postoperative day 2,there were statistically significant differences in dyspnea(P=0.002),exercise capacity(P=0.001)and anxiety(P<0.001)between the three groups.Compared with the control,the yoga breathing exercises based on the ADOPT mode group significantly improved dyspnea(P=0.003),exercise capacity(P=0.001)and anxiety(P<0.001),and the differences had statistical significant;The yoga breathing exercises group significantly improved dyspnea(P=0.018)and anxiety(P=0.004)compared with the control group,and the differences were statistically significant.(4)On the discharge day,there were statistically significant differences in dyspnea(P<0.001),exercise capacity(P=0.003),anxiety(P<0.001),QOL functional scales(P=0.034),QOL symptom scales(P=0.026),global QOL(P=0.04),QOL lung cancer scales(P=0.011)and total in-hospital stay(P=0.009)among the three groups.The yoga breathing exercises based on the ADOPT mode group significantly improved dyspnea(P<0.001),exercise capacity(P =0.003),anxiety(P <0.001),QOL functional scales(P=0.030),QOL symptom scales(P=0.023),global QOL(P=0.035),QOL lung cancer scales(P=0.013)and total in-hospital stay(P=0.011)compared with the control group,with statistical significance;Compared with the control group,the yoga breathing exercises group significantly improved dyspnea(P =0.019)and anxiety(P=0.002),and the difference had statistical significance;Compared with the yoga breathing exercises group,the yoga breathing exercises based on the ADOPT mode group significantly improved exercise capacity(P=0.047)as well as compliance(P<0.001),with statistical significance.(5)No significant differences were found in postoperative pulmonary complications(P=0.915)or time of thoracic drainage tube insertion after operation(P=0.062)among the three groups.No significant difference was found in depression among the three groups on the first day before surgery(P=0.725),the second day after surgery(P=0.910)and the discharge day(P=0.776).Conclusion:Compared with usual care,yoga breathing exercises based on the ADOPT mode can significantly improve patients’ dyspnea,exercise capacity,anxiety and quality of life,and shorten hospitalization time.Compared with usual care,yoga breathing exercises can significantly improve patients’ dyspnea and anxiety,but the benefits of exercise capacity,quality of life and hospitalization time need further research.There were no statistical differences among the three groups in depression,postoperative pulmonary complications or postoperative indwelling time of thoracic drainage tube.Compared with yoga breathing exercises,yoga breathing exercises based on the ADOPT mode can significantly improve patients’ exercise capacity as well as compliance,and produce better rehabilitation effect.The results of this study showed that yoga breathing exercises based on the ADOPT mode seems to be able to improve the physical and mental status of patients with lung cancer surgery,shorten hospitalization time and help them recover.