Understanding the Feasibility of a Co-designed Pre-radiotherapy Exercise Programme - A Single-arm Study

This is a sequential, mixed method feasibility study consisting of two phases: Phase 1: Quantitative data collection (feasibility outcomes) Phase 2: Qualitative data collection (semi-structured interviews) The exercise programme used in this study was co-designed through a series of workshops and meetings involving individuals affected by lung cancer and healthcare professionals. Eligible participants must be receiving a prescribed radiotherapy dose of either 55 Gy delivered in twenty fractions or 66Gy administered in 15 fractions, adminstered daily over a 3-4 week period. Accordingly, participants will be prescribed either 15 or 20 exercise sessions, performed once daily and scheduled in alignment with their radiotherapy treatment. Exercise intensity is personalised and based on a submaximal exercise test conducted at the participant's baseline assessment. This test will be used to determine each participant's maximum heart rate, which will then be entered into the Karvonen formula (Karvonen et al., 1957) to calculate percentage heart rate reserve. This calculation will establish individual heart-rate ranges corresponding to light, moderate, and vigorous exercise intensities. Starting exercise intensity level (1-4) will be determined based on a baseline six-minute walking test, clinical frailty score, and participant preference. The four levels of exercise intensity increase in difficulty, and incorporate various durations of light, moderate, or high intensity exercise, including: * Level 1: 10-minute warm-up at light intensity continuous cycling followed by 10 minutes of moderate intensity continuous cycling * Level 2: 5-minute warm-up at light intensity continuous cycling followed by 15 minutes of moderate intensity continuous cycling * Level 3: 5-minute warm-up at light intensity continuous cycling, followed by 10 minutes of moderate intensity continuous cycling, and 5 minutes of 30-second-high intensity intervals * Level 4: 5-minute warm-up at light intensity continuous cycling, followed by 5 minutes of 30-second-high intensity intervals, 5 minutes of moderate intensity continuous cycling, and 5 minutes of 30-second-high intensity intervals All participants will wear a chest-strap heart-rate monitor during each exercise session to ensure they are exercising at the prescribed intensity. Session adherence will be defined as completion of at least 75% of the prescribed exercise duration (i.e. 15-minutes).