Skip to main content
. 2019 Feb 11;2019(2):CD012685. doi: 10.1002/14651858.CD012685.pub2

Hwang 2012.

Methods Design: Randomised controlled trial
 Setting: outpatient clinic, Taiwan
 Study duration: 8 weeks
Participants 44 participants with stage NSCLC being treated with epidermal growth factor receptor inhibitors were invited. 24 randomised, 18 completed.
111 participants participated.
Exercise group: n = 13 (5 M), mean age 61 (6.3) years, BMI 22.6 (2.4), 77% stage IV, 0 were current or ex smokers, 2.6 (2.1) months following diagnosis.
Control group: n = 11 (7 M), mean age 58.5 (8.2) years, 91% stage IV, 1 was current or ex‐smokers, 2.8 (2.4) months post diagnosis.
Interventions Exercise (n=13): eight weeks of aerobic exercise 30‐40min, 2‐5 min intervals; intervals 80% VO2peak or RPE 15‐17, 60% VO2peak RPE 11‐13; 10 min warm up, 5 min cool down, performed 3 times per week.
Control (n=11): usual care, general patient education, and social phone calls every 2–3 weeks, without supervised exercise intervention. General exercise instructions with the Theraband® Elastic Band were given if the subjects in the control group specifically asked for exercise consultation.
Outcomes Exercise capacity (VO2peak), muscle force‐generating capacity (peak torque; right quad; isokinetic Biodex Nm), HRQoL (EORTC Global), dyspnoea (EORTC dyspnoea), fatigue (EORTC Fatigue)
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk Quote: "A computer number generator was used to assign a random order..."
Quote: "A minor reallocation was made at the beginning of the study..."
Comment: three participants were reallocated based on patient preference.
Allocation concealment (selection bias) Unclear risk Quote: "This allocation procedure was performed by an individual who was unaware of the purpose of this study."
Comment: insufficient information to permit judgment of 'low risk' or 'high risk'
Blinding of participants and personnel (performance bias) 
 All outcomes High risk Comment: no blinding of participants and personnel
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Quote: "All tests were performed by a blinded assessor".
Comment: blinding of outcome assessment ensured, and unlikely that the blinding could have been broken
Incomplete outcome data (attrition bias) 
 All outcomes High risk Comment: there was higher dropout from the intervention group compared to the control group.
Comment: potentially inappropriate application of simple imputation (baseline observation carried forward)
Selective reporting (reporting bias) Unclear risk Comment: no protocol available. Insufficient information to permit judgment of 'low risk' or 'high risk'
Other bias Low risk Comment: the study appears to be free of other sources of bias.