Investigation of the Effects of Tele-Yoga Training in Individuals With Lung Cancer Undergoing Lung Resection Surgery

Lung carcinoma, also referred to as pulmonary carcinoma, is a malignant tumorcharacterized by uncontrolled cell proliferation in the lung tissue, originating fromepithelial cells. It is the most commonly diagnosed cancer type globally.Histopathologically, lung cancer is classified into two main categories: non‐small celllung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC constitutes approximately85% of all lung cancer cases and is associated with high morbidity and mortality.According to the Tumor‐Node‐Metastasis (TNM) staging system developed by the AmericanJoint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC),NSCLC is staged from I to IV. While SCLC has a lower prognostic value within the TNMsystem and is rarely operable, NSCLC is typically treated surgically in early stages.Surgical treatment for early state of lung cancer includes lobectomy, pneumonectomy,segmentectomy, or wedge resection, depending on tumor location, lung function, anddisease stage. The most commonly employed surgical approaches are thoracotomy,video‐assisted thoracoscopic surgery (VATS), and robot‐assisted thoracoscopic surgery(RATS). Although techniques such as VATS are associated with less postoperative pain,faster recovery, and better preservation of pulmonary function compared to thoracotomy,surgery still significantly reduces exercise capacity and contributes to long‐termphysical and psychological limitations.Following lung resection, patients often experience a decline in exercise capacity,attributed to loss of lung parenchyma, ventilatory limitations, increased cardiacworkload, thoracic pain, and muscle weakness. Dyspnea is prevalent in up to 60% ofpostoperative patients, many of whom did not experience dyspnea prior to surgery.Additionally, adjuvant chemotherapy and/or radiotherapy may cause pulmonary inflammationand fibrosis, further reducing lung function and quality of life. Sleep disturbances andpsychological disorders such as anxiety and depression are also common during thisperiod.Exercise training is a non‐pharmacological intervention that improves immune function andquality of life in cancer patients; however, traditional pulmonary rehabilitationprograms are often underutilized postoperatively. There is increasing interest inmind‐body exercise (MBE) modalities such as yoga, tai chi, and qigong, which integratephysical postures, breath control, and meditation. Among these, yoga has shown potentialto improve exercise capacity, pulmonary function, muscle strength, fatigue, anxiety,depression, and sleep quality. Despite promising findings, there is a lack of evidenceregarding the efficacy of structured yoga interventions specifically tailored for lungcancer patients post‐surgery.Furthermore, the transition from hospital to home poses challenges in ensuring thecontinuity and accessibility of rehabilitation services. Telehealth, defined as theprovision of healthcare services via digital communication technologies, has emerged as afeasible platform for delivering home‐based interventions. Tele‐yoga, a form of remotesupervised yoga practice, has shown benefits in various populations, including those withchronic obstructive pulmonary disease (COPD), heart failure, sleep apnea, and ankylosingspondylitis. However, no study has yet examined its application in post‐surgical lungcancer patients.Based on this gap in the literature, the present study aims to investigate the effects ofan 8‐week synchronized tele‐yoga intervention on exercise capacity, pulmonary function,respiratory and peripheral muscle strength, physical activity level, dyspnea, fatigue,sleep quality, anxiety, depression, and health‐related quality of life in patients whohave undergone lung resection surgery for lung cancer. This will be the first randomizedcontrolled trial to assess a comprehensive yoga‐based telerehabilitation approach in thispopulation. The findings may provide a cost‐effective and practical home‐basedrehabilitation strategy to enhance physical and psychological recovery in lung cancersurvivors.