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Three-Ball Mindfulness Breathing Training Improves Recovery After Lung Cancer Lobectomy
Adding structured three-ball mindfulness breathing exercises to standard pulmonary rehabilitation after lung cancer lobectomy produced measurably shorter hospital stays, reduced dyspnea scores, better exercise tolerance, and lower fatigue and psychological distress compared with conventional rehabilitation alone. While these functional improvements were statistically significant, the absence of a significant difference in complication rates between groups means the intervention’s impact on clinical safety endpoints remains uncertain.
What Was Studied
This trial investigated whether combining three-ball incentive spirometry with mindfulness-based breathing techniques—layered on top of standard postoperative pulmonary rehabilitation—could improve recovery outcomes in patients who had undergone pulmonary lobectomy for lung cancer. Lobectomy carries substantial physiological burden, and optimizing early respiratory rehabilitation is an active area of clinical research given the risks of postoperative pulmonary complications, prolonged hospital stay, and impaired quality of life.
How It Was Studied
This was a single-center randomized controlled trial conducted at the First Affiliated Hospital of Xiamen University, enrolling 124 patients with lung cancer who underwent pulmonary lobectomy between March 2024 and January 2025. Participants were allocated in equal groups of 62 using a random number table. The control group received conventional pulmonary rehabilitation, while the observation group received the three-ball mindfulness breathing protocol in addition to the standard regimen. Assessments were conducted at four time points—admission, one day before surgery, three days after surgery, and one week after discharge—covering recovery indicators, dyspnea (mMRC scale), exercise capacity (six-minute walk test, 6MWT), emotional status (Depression Anxiety Stress Scale, DASS), and fatigue (Piper Fatigue Scale, PFS).
What Was Observed
- Patients in the intervention group had statistically shorter durations of pulmonary rales, sputum retention, and total hospital stay compared to the control group (P < 0.05). These are clinically meaningful recovery markers indicating faster airway clearance and earlier readiness for discharge.
- At postoperative day 3 and one week after discharge, the observation group reported meaningfully lower dyspnea severity on the mMRC scale and covered greater distance on the 6MWT than controls (P < 0.05), indicating both reduced breathlessness and improved functional exercise capacity at two key recovery milestones.
- Psychological distress and fatigue, measured by DASS and PFS scores respectively, were lower in the intervention group at all three postoperative assessment points—one day before surgery, three days after surgery, and one week after discharge—suggesting the mindfulness component may begin influencing emotional and fatigue outcomes even in the preoperative preparatory phase (P < 0.05).
- The rate of postoperative complications did not differ significantly between groups (9.68% in the observation group versus 17.74% in the control group), meaning the observed numerical difference in complication incidence was not statistically reliable (P > 0.05), and no firm conclusion about complication reduction can be drawn.
Why This Matters
Enhanced recovery after thoracic surgery programs increasingly prioritize multimodal interventions that address not only physical lung function but also patient-reported outcomes such as fatigue and psychological wellbeing. This trial adds structured evidence that incorporating mindfulness principles into a physical breathing device protocol may extend benefits beyond spirometry alone. If replicated in larger, multi-center settings, this approach could inform rehabilitation protocol design for thoracic oncology patients.
How to Read This Result
This is a single-center trial with a relatively modest sample size and a short follow-up window of one week post-discharge, which limits the generalizability of the findings and precludes conclusions about longer-term recovery or survival outcomes.
Limitations
The abstract does not explicitly report study limitations.