Impact of breathing exercises in subjects with lung cancer undergoing surgical resection: A systematic review and meta-analysis

J Clin Nurs. 2019 Mar;28(5-6):717-732. doi: 10.1111/jocn.14696. Epub 2018 Nov 20.


Aims and objectives: To assess the effects of breathing exercises on postoperative pulmonary complications (PPCs), pulmonary function, 6-min walk distance (6MWD) and the length of hospital stay (LOS) in lung cancer patients undergoing lung surgery.

Background: Lung cancer patients undergoing lung resection have poor pulmonary function and multiple PPCs. Breathing exercises may improve these symptoms.

Design: Systematic literature review and meta-analysis were conducted.

Methods: All entries to the following databases were searched up until 20 December 2017: PubMed, EMBASE Ovid, the Cochrane Central Register of Randomized Controlled Trials, Web of Science, Wanfang, Weipu and Chinese National Knowledge Infrastructure databases. Only randomised controlled trials (RCTs) were included in the analysis.

Results: A total of sixteen articles including nine articles in Chinese language and seven articles in English met the inclusion criteria. Breathing exercises decreased PPCs, and in addition, the incidence of pneumonia and atelectasis in the postoperative subgroup was reduced. Predicted forced expiratory volume in 1 s (predicted FEV1 %), predicted forced vital capacity (predicted FVC%), FVC and FEV1 /FVC ratio had improved after breathing exercises, but the changes in FEV1 were not statistically significant. Furthermore, the LOS was significantly decreased, but no improvements were found in 6MWD.

Conclusions: The results showed that breathing exercises could improve lung function, decrease the incidence of PPCs and LOS in a sample of lung cancer patients undergoing pulmonary surgery.

Relevance to clinical practice: The analysis suggests that breathing exercises should be considered as a respiratory rehabilitation programme for lung cancer patients undergoing lung surgery in clinical practice.

Keywords: breathing exercises; lung cancer; meta-analysis; systematic review.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Breathing Exercises / methods*
  • Forced Expiratory Volume
  • Humans
  • Length of Stay
  • Lung Neoplasms / rehabilitation*
  • Lung Neoplasms / surgery*
  • Pneumonia / prevention & control
  • Postoperative Complications / prevention & control*
  • Postoperative Period
  • Randomized Controlled Trials as Topic
  • Tidal Volume