From Living Room to Operating Room for Patients with Pulmonary Surgeries: A Systematic Review of Literature

Introduction: This systematic review aimed to evaluate the effectiveness of preoperative home-based exercise training on clinical outcomes in patients undergoing pulmonary surgery. Methods: A comprehensive literature search was conducted on 25 October 2024, in PubMed, Scopus, PEDro, and Cochrane databases for English-language studies published between 2014 and 2024. Randomized controlled trials, non-randomized trials, feasibility studies, and cohort studies involving adults scheduled for pulmonary surgery and receiving home-based prehabilitation were included. Methodological quality was assessed using the PEDro Quality Assessment scale and i-CONTENT tool. Results: Six studies involving patients undergoing pulmonary surgery were included, of which three were randomized controlled trials. Two studies were rated as excellent quality, one as good, two as moderate, and one as poor. Interventions ranged from 2 to 12 weeks and generally included aerobic or functional training. Compared to usual care, participants in home-based exercise groups showed improvements in physical capacity (e.g., 6-min walk test, sit-to-stand), enhanced quality of life, and reduced hospital length of stay. Conclusions: Preoperative home-based exercise training appears to be a feasible and effective approach to improve functional outcomes and reduce hospitalization after pulmonary surgery. However, heterogeneity in study design and quality limits generalizability, highlighting the need for further high-quality trials.