Effects of respiratory muscle training on psychological status and physical health of depression with sleep disorders in radiotherapy for lung cancer

  • Yannan Zhang Department of Nursing, Affiliated Hospital of Nantong University, Nantong 226001, China
  • Yingying Xu Department of Nursing, Affiliated Hospital of Nantong University, Nantong 226001, China
Article ID: 3682
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Keywords: breathing exercises; depression; lung neoplasms; radiotherapy; sleep wake disorders

Abstract

Recent years have seen a growing incidence of lung cancer (LC). This study explored the effect of respiratory muscle training (RMT) combined with vitamin B6 on patients with depression combined with sleep disorders (DSD). By comparing the Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS)/self-rating depression scale (SDS) of the three groups of DSD patients who received conventional rehabilitation training (n = 54), the control group who received conventional rehabilitation training combined with vitamin B6 (n = 47), and the combined group who received RMT combined with vitamin B6 (n = 65), we found that the Pittsburgh sleep quality index (PSQI), the self-rating anxiety scale (SAS)/self-rating depression scale (SDS) of the combined group were significantly lower than the PSQI. scale (SAS)/self-rating depression scale (SDS) and Clinical frailty scale (CFS) in the three groups of DSD patients, and we found that the sleep disorder, psychological status and cancer-related fatigue in the combined group were more significantly improved (P < 0.05). Meanwhile, the nutritional status of the combined group after treatment was also more favorable than the other two groups (P < 0.05). Finally, through one-year prognostic follow-up, we found that although there was no difference in prognostic survival rate and tumor recurrence rate among the three groups (P > 0.05), the Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC) score was higher in the combined group (P < 0.05). These results suggest that RMT combined with vitamin B6 can lay a more reliable foundation for the prognosis and rehabilitation of patients with DSD.

Published
2025-08-13
How to Cite
Zhang, Y., & Xu, Y. (2025). Effects of respiratory muscle training on psychological status and physical health of depression with sleep disorders in radiotherapy for lung cancer. Psycho-Oncologie, 19(3), 3682. https://doi.org/10.18282/po3682
Section
Article

References

1. Bade BC, Dela Cruz CS. Lung Cancer 2020: Epidemiology, Etiology, and Prevention. Clin Chest Med. 2020; 41(1): 1–24. doi: 10.1016/j.ccm.2019.10.001

2. Thai AA, Solomon BJ, Sequist LV, et al. Lung cancer. Lancet. 2021; 398(10299): 535–554.

3. Zhou Z, Guan B, Xia H, et al. Particle radiotherapy in the era of radioimmunotherapy. Cancer Lett. 2023; 567: 216268.

4. Manem VS, Taghizadeh-Hesary F. Advances in personalized radiotherapy. BMC Cancer. 2024; 24(1): 556.

5. Rades D, Kopelke S, Soror T, et al. Risk Factors for Sleep Disturbances in Patients Scheduled for Radiotherapy of Head-and-Neck Cancer. Anticancer Res. 2021; 41(10): 5065–5069.

6. Phillips KM, Jim HS, Donovan KA, et al. Characteristics and correlates of sleep disturbances in cancer patients. Support Care Cancer. 2012; 20(2): 357–365.

7. Jimeno-Almazan A, Buendia-Romero A, Martinez-Cava A, et al. Effects of a concurrent training, respiratory muscle exercise, and self-management recommendations on recovery from post-COVID-19 conditions: the RECOVE trial. Journal of Applied Physiology (1985). 2023; 134(1): 95–104.

8. Laveneziana P, Albuquerque A, Aliverti A, et al. ERS statement on respiratory muscle testing at rest and during exercise. Eur Respir J. 2019; 53(6): 1801214.

9. Yan H, Jin X, Yin L, et al. Investigating Causal Associations of Circulating Micronutrients Concentrations with the Risk of Lung Cancer: A Mendelian Randomization Study. Nutrients. 2022; 14(21): 4569.

10. Wang Z, Feng F, Wu Q, et al. Disodium Cantharidinate and Vitamin B6 Injection Adjunct with Platinum-Based Chemotherapy for the Treatment of Advanced Non-Small-Cell Lung Cancer: A Meta-Analysis. Evid Based Complement Alternat Med. 2019; 2019: 9386273.

11. Paulin FV, Zagatto AM, Chiappa GR, Muller PT. Addition of vitamin B12 to exercise training improves cycle ergometer endurance in advanced COPD patients: A randomized and controlled study. Respir Med. 2017; 122: 23–29.

12. Kutob L, Schneider F. Lung Cancer Staging. Surg Pathol Clin. 2020; 13(1): 57–71.

13. Zitser J, Allen IE, Falgas N, et al. Pittsburgh Sleep Quality Index (PSQI) responses are modulated by total sleep time and wake after sleep onset in healthy older adults. PLoS One. 2022; 17(6): e0270095.

14. Dunstan DA, Scott N. Norms for Zung’s Self-rating Anxiety Scale. BMC Psychiatry. 2020; 20(1): 90.

15. Church S, Rogers E, Rockwood K, Theou O. A scoping review of the Clinical Frailty Scale. BMC Geriatr. 2020; 20(1): 393.

16. Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2016; 13: 67–75.

17. Gao YH, Guan WJ, Xu G, et al. Validation of the Mandarin Chinese version of the Leicester Cough Questionnaire in bronchiectasis. Int J Tuberc Lung Dis. 2014; 18(12): 1431–1437.

18. Avancini A, Sartori G, Gkountakos A, et al. Physical Activity and Exercise in Lung Cancer Care: Will Promises Be Fulfilled? Oncologist. 2020; 25(3): e555–e569.

19. Li CY, Song YJ, Zhao L, et al. Insomnia Burden among Informal Caregivers of Hospitalized Lung Cancer Patients and Its Influencing Factors. Biomed Environ Sci. 2023; 36(8): 715–724.

20. Huang BH, Duncan MJ, Cistulli PA, et al. Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk. Br J Sports Med. 2022; 56(13): 718–724.

21. Qi J, Zheng Y, Li B, et al. Mechanism of vitamin B6 benzoyl hydrazone platinum(II) complexes overcomes multidrug resistance in lung cancer. Eur J Med Chem. 2022; 237: 114415.

22. Lemoine P, Bablon JC, Da Silva C. A combination of melatonin, vitamin B6 and medicinal plants in the treatment of mild-to-moderate insomnia: A prospective pilot study. Complement Ther Med. 2019; 45: 104–108.

23. Wada JT, Borges-Santos E, Porras DC, et al. Effects of aerobic training combined with respiratory muscle stretching on the functional exercise capacity and thoracoabdominal kinematics in patients with COPD: a randomized and controlled trial. Int J Chron Obstruct Pulmon Dis. 2016; 11: 2691–2700.

24. Lee C, Alexander E, Lee R, et al. Behavioral interventions for asthma self-management in South Asian populations: a systematic review. J Asthma. 2021; 58(1): 112–120.

25. Liu L, Yu H, Bai J, et al. Positive Association of Serum Vitamin B6 Levels with Intrapulmonary Lymph Node and/or Localized Pleural Metastases in Non-Small Cell Lung Cancer: A Retrospective Study. Nutrients. 2023; 15(10): 2340.

26. Gea J, Sancho-Munoz A, Chalela R. Nutritional status and muscle dysfunction in chronic respiratory diseases: stable phase versus acute exacerbations. J Thorac Dis. 2018; 10(Suppl 12): S1332–S1354.

27. Katayifci N, Bosnak Guclu M, Sen F. A comparison of the effects of inspiratory muscle strength and endurance training on exercise capacity, respiratory muscle strength and endurance, and quality of life in pacemaker patients with heart failure: A randomized study. Heart Lung. 2022; 55: 49–58.

28. Fabero-Garrido R, Del Corral T, Angulo-Diaz-Parreno S, et al. Respiratory muscle training improves exercise tolerance and respiratory muscle function/structure post-stroke at short term: A systematic review and meta-analysis. Ann Phys Rehabil Med. 2022; 65(5): 101596.

29. Chung Y, Huang TY, Liao YH, Kuo YC. 12-Week Inspiratory Muscle Training Improves Respiratory Muscle Strength in Adult Patients with Stable Asthma: A Randomized Controlled Trial. Int J Environ Res Public Health. 2021; 18(6): 3267.

30. Aquino TN, Prado JP, Crisafulli E, Clini EM, Galdino G. Efficacy of Respiratory Muscle Training in the Immediate Postoperative Period of Cardiac Surgery: A Systematic Review and Meta-Analysis. Braz J Cardiovasc Surg. 2024; 39(1): e20220165.