Effect of home-based walking exercise and education on early functional recovery after lung cancer surgery: protocol for the WalkLung multicentre randomised controlled trial.

The WalkLung trial is designed as a multicentre, parallel-group, randomised controlled trial conducted at three hospitals in China with stratification by study centre.

• The trial is registered under ChiCTR2500103081.
• Ethical approval was obtained from the Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital (No. SCCHEC-02-2025-091) and all participating subcentres.
• The protocol version is V.1.0, dated 2 January 2025.
• Written informed consent will be obtained from all participants.

A total of 116 postoperative lung cancer patients will be randomised in a 1:1 ratio to either the intervention group or the control group.

• The intervention group will receive home-based walking exercise and education for 4 weeks.
• The control group will receive usual care.
• Randomisation is stratified by study centre.

The primary outcome is the longitudinal walking difficulty score during the 4-week postdischarge period, measured by the validated perioperative symptom assessment for lung surgery scale.

• The walking difficulty scale ranges from 0 to 10.
• Assessments will be conducted at discharge and weekly for 4 weeks.
• The perioperative symptom assessment for lung surgery scale is described as a validated instrument.

The trial includes multiple secondary outcomes and long-term outcomes assessed up to 6 months post-intervention.

• Secondary outcomes include the 6-min walk test, pulmonary function, complications, physical activity level, quality of life, social functioning, exercise adherence, and adverse events.
• Long-term outcomes up to 6 months will be analysed and reported separately.
• All analyses will use an intention-to-treat approach.
• Outcome measures will be analysed using generalised estimating equations for repeated measures, and t-tests or χ2 tests as appropriate.

Walking is characterised in the study background as a simple, low-cost and easily implemented form of exercise that offers multiple health advantages.

• The intervention specifically targets early functional recovery after lung cancer surgery.
• The home-based format is designed to be accessible in the postdischarge period.
• The intervention duration is 4 weeks following hospital discharge.