Evidence map›Paper›PMID 36539175›Full record

SynthesisArchives of physical medicine and rehabilitation2023

Post-Operative Outcomes of Pre-Thoracic Surgery Respiratory Muscle Training vs Aerobic Exercise Training: A Systematic Review and Network Meta-analysis.

Rajesh Kunadharaju, Arjun Saradna, Andrew Ray, Han Yu, Wenyan Ji, Michelle Zafron, Martin Jeffery Mador

Registry-linked trialOpen access · greenAbstract readSystematic ReviewNetwork Meta-Analysis
In one paragraph

Synthesis in Archives of physical medicine and rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06716437 (Digitally Enabled Prehabilitation in a Community-based Setting for Patients Undergoing Lung Cancer Surgery), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06716437 narecruitingnot on this mapstarted 2025, after this paper: background citation

Digitally Enabled Prehabilitation in a Community-based Setting for Patients Undergoing Lung Cancer Surgery

TypeinterventionalSponsorUniversity of MelbourneRan2025 to 2025Enrolled25ConditionsLung Cancer (NSCLC)ArmsPrehabilitation
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Preoperative prehabilitation in adults: A concept analysis.International journal of nursing studies advances · 2026
    Review
  4. Review
  5. Review
  6. Observational
  7. Article
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Rajesh KunadharajuUniversity at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY. Electronic address: drrajesh125@gmail.com.
Arjun SaradnaUniversity at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY.
Andrew RayRoswell Park Comprehensive Cancer Center, Department of Cancer Prevention & Control, Buffalo, NY.
Han YuRoswell Park Comprehensive Cancer Center, Department of Biostatistics and Bioinformatics, Buffalo, NY.
Wenyan JiVirginia Polytechnic Institute and State University, Center for Biostatistics and Health Data Science, Blacksburg, VA.
Michelle ZafronUniversity at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Reference and Education Services, Buffalo, NY.
Martin Jeffery MadorUniversity at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Department of Pulmonary, Critical Care, and Sleep Medicine, Buffalo, NY; VA WNY Healthcare System, Buffalo, NY.
Roswell Park Comprehensive Cancer Center · USUniversity at Buffalo, State University of New York · USJacobs Institute · USVA Western New York Healthcare System · USVirginia Tech · US

Funding

Two-Spirit Films in Indigenous Cancer HealthP30CA016056 · NCI · ROSWELL PARK CANCER INSTITUTE CORP · PI CANDACE S JOHNSON · 1985 to 2026
$116.6M
Preoperative Respiratory Muscle Training to Prevent Postoperative Pulmonary Complications in Patients Undergoing Resection for Lung CancerR01CA222382 · NCI · ROSWELL PARK CANCER INSTITUTE CORP · PI RAY, ANDREW DONALD · 2018 to 2022
$3.0M
NCI NIH HHS P30 CA016056NCI NIH HHS R01 CA222382
6 · The paper itself

Abstract

objectiveTo compare the postoperative outcomes of preoperative respiratory muscle training (RMT) with a device to preoperative aerobic exercise training (AET) in patients undergoing thoracic surgeries (cardiac and lung). DATA SOURCES: PubMed, EMBASE, Cochrane, and Web of Science were comprehensively searched upon inception to 9/2020. STUDY SELECTION: All randomized control studies, including preoperative RMT and preoperative AET compared with a non-training control group, were included. DATA EXTRACTION: The meta-analysis was performed for outcomes including postoperative pulmonary complications (PPC), pneumonia, postoperative respiratory failure (PRF), hospital length of stay (HLOS), and mortality. We performed a network meta-analysis based on Bayesian random-effects regression models. DATA SYNTHESIS: A total of 25 studies, 2070 patients were included in this meta-analysis. Pooled data for the patients who performed RMT with a device showed a reduction in PPCs, pneumonia, PRF with odds ratio (OR) of 0.35 (P value .006), 0.38 (P value .002), and 0.22 (P value .008), respectively. Pooled data for the patients who performed AET showed reduction in PPC, pneumonia with a OR of 0.33 (P value <.00001) and OR of 0.54 (P value .01), respectively. HLOS was decreased by 1.69 days (P value <.00001) by performing RMT and 1.79 days (P value .0008) by performing AET compared with the usual group. No significant difference in all-cause mortality compared with usual care in both RMT and AET intervention groups. No significant difference in the incidence of PRF compared with usual group in RMT + AET and AET alone intervention groups (OR 0.32; P=.21; OR 0.94; P=.87). Based on rank probability plots analysis, on network meta-analysis, RMT and AET ranked similarly on the primary outcome of PPC and secondary outcomes of pneumonia, PRF and HLOS.

conclusionsIn thoracic surgeries, preoperative RMT is comparable with preoperative AET to prevent PPC, pneumonia, and PRF and reduce HLOS. It can be considered in patients in resource-limited settings.

Indexed as

PneumoniaThoracic SurgeryBayes TheoremBreathing ExercisesExerciseHumansPostoperative ComplicationsAerobic exerciseBreathing exercisesLength of stayPneumoniaPostoperative complicationsRehabilitation

Identifiers

PMID36539175
PMCPMC11808535
OpenAlexW4311817993

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.