Fit 4 Surgery 2: A randomised controlled trial to investigate an App-based, motivation-theory grounded, personalised, comprehensive, prehabilitation programme in addition to usual care versus usual care alone to enhance recovery of physical function and reduce complications after lung cancer surgery
Recovery from lung cancer surgery
TRIAL INTERVENTION Usual Care vs F4S-2 digital platform (App) and Usual care Usual Care: This may be a range of healthcare services that provide all or one of the following: information for the participant (with or without links to further information), formal rehabilitation via physiotherapy, nutritional support via dietitian, and/or routine follow up as per standard of care. THE F4S-2 APP The advice given to the participant is determined by their unique, dynamic, personal health status. That is, as a patient engages with the App, the advice regarding exercise and nutrition adapts. Specifically, the App collects baseline demographic data, comorbidities, symptom burden using simple questions and Visual Analogue Scales, and the outcome measures of Quality of Life, Health and wellbeing scores. This information is used to deliver personalised feedback, support and guidance when using the App. e.g. if diabetic, guidance on avoiding a hypoglycaemic event. This will not constitute trial data, and is part of the data to inform the intervention itself. The digital programme or ‘App’ comprises three prehabilitation interventions. STRUCTURED HOME EXERCISE PROGRAMME: Participants are guided through a series of screens to build their own programme, including a range of strengthening, mobility and cardiovascular exercises. Baseline suggestions on programme level/ intensity are made based on a ‘sit to stand test’ conducted within the App. Once the programme is built, participants are encouraged to exercise daily to achieve 150 minutes of exercise/week as per pulmonary rehabilitation guidelines. Heart rate is recorded using a wearable sensor provided free of charge to the participants. Once each exercise is completed, the participant inputs their perceived intensity using the BORG perceived exertion scales to the App. This data is used to encourage the participant via personalised messages to increase or decrease intensity at the next session to achieve the target intensity
1. Adults aged 18 years or over 2. With a suspected clinical or pathological diagnosis of primary lung cancer 3. Selected for elective curative lung resection 4. Able to undergo F4S.2 intervention for minimum 2 weeks prior to surgery 5. Willing and able to provide informed consent 6. Willing to use F4S app 7. Willing to complete study questionnaires
1. Emergency surgery 2. Patients requiring parenteral nutrition