Structured Pulmonary Physiotherapy After Lung Cancer Surgery by Age Group

This interventional study aims to evaluate the effectiveness of a structured pulmonary physiotherapy program applied after lung cancer surgery across different age groups. Patients aged 45 years and older undergoing lung resection will be included and categorized into two age groups (45-60 years and ≥60 years) for subgroup analysis.

The structured postoperative pulmonary physiotherapy program is initiated in the early postoperative period and continued until hospital discharge. The program includes chest physiotherapy techniques, early mobilization, postural exercises, and incentive spirometry training. The intervention is delivered once daily under physiotherapist supervision, and participants are instructed to continue prescribed breathing, incentive spirometry, and mobilization exercises independently during the afternoon and evening sessions.

The primary outcome measure is length of hospital stay. Secondary outcomes include postoperative pain assessed by Visual Analog Scale (VAS), dyspnea and fatigue assessed by Borg scale, oxygen saturation, hemodynamic parameters, and inflammatory and biochemical markers including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), albumin, prealbumin, creatine kinase (CK), and lactate dehydrogenase (LDH).

Clinical, physiological, and biochemical outcomes are assessed from the early postoperative period until hospital discharge. The study further aims to explore potential differences in treatment response between predefined age groups. No randomization or control group is included, as all participants receive the same structured physiotherapy intervention.

Inclusion criteria

• Patients aged 45 to 90 years
• Undergoing lung cancer surgery (lobectomy, segmentectomy, or pneumonectomy)
• Medically stable in the early postoperative period
• Able to participate in a structured pulmonary physiotherapy program
• Provided written informed consent

Exclusion criteria

• Hemodynamic instability preventing mobilization
• Severe cognitive impairment limiting cooperation
• Neurological or orthopedic conditions restricting mobilization
• Requirement for prolonged mechanical ventilation
• Presence of another active malignancy
• Any medical contraindication to physiotherapy as determined by the attending physician