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Rehabilitation in Patients before and after Lung Transplantation.

Respiration; international review of thoracic diseases
January 1, 2015
Daniel Langer
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of rehabilitation interventions, including supervised exercise training and pedometer-based walking, in improving exercise capacity and quality of life for lung transplant recipients before and after transplantation.

Results Summary

Outpatient rehabilitation programs, including supervised exercise training, were effective in improving limb muscle dysfunction, exercise capacity, and quality of life for lung transplant recipients. Remotely monitored home-based exercise or pedometer-based walking interventions showed promise as alternatives to supervised programs in the long-term posttransplant phase.

Population

Patients with end-stage lung disease, both pre- and post-lung transplantation.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (2)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Outpatient rehabilitation programs including supervised exercise training
increase
limb muscle dysfunction, exercise capacity, and QOL
patients before and after lung transplantation
-
have been shown to be effective in improving
#1
Remotely monitored (telehealth) home-based exercise or pedometer-based walking interventions
no change
rehabilitation outcomes
lung transplant recipients in the long-term posttransplant phase
-
might be interesting alternatives to supervised outpatient rehabilitation interventions
#2
Abstract

Lung transplantation is an established treatment for patients with end-stage lung disease. It has been observed that despite near-normal lung function, exercise intolerance and reductions in quality of life (QOL) often persist up to years after transplantation. Several modifiable pre- and posttransplant factors are known to contribute to these persisting impairments. Physiological changes associated with severe and chronic lung disease, limb muscle dysfunction, inactivity/deconditioning, and nutritional depletion can affect exercise capacity and physical functioning in candidates for lung transplantation. After transplantation, extended hospital and intensive care unit stay, prolonged sedentary time, persisting inactivity, immunosuppressant medications and episodes of organ rejection may all impact lung recipients' recovery. Available evidence will be reviewed and content will be proposed (both evidence and experience based) for rehabilitation interventions prior to transplantation, during hospitalization after transplantation, and in both the immediate (≤12 months after hospital discharge) and long-term (>12 months after hospital discharge) posttransplant phase. Outpatient rehabilitation programs including supervised exercise training have been shown to be effective in improving limb muscle dysfunction, exercise capacity, and QOL both before and after transplantation if offered appropriately. Unmet research needs included the absence of sufficiently powered randomized controlled trials measuring the effects of rehabilitation interventions on crucial long-term outcomes such as sustained improvements in QOL, participation in daily activity, survival, incidence of morbidities and cost-effectiveness. Remotely monitored (telehealth) home-based exercise or pedometer-based walking interventions might be interesting alternatives to supervised outpatient rehabilitation interventions in the long-term posttransplant phase and warrant further investigation.

Medical Subject Headings (MeSH)
Early AmbulationExerciseExercise ToleranceHospitalizationHumansLung TransplantationMuscle StrengthMuscle WeaknessPatient Education as TopicPostoperative CarePreoperative CareQuality of Life
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations55
Citations/Year5.5
Relative Citation Ratio2.68
NIH Percentile82.5%
Research Impact Scores
APT Score0.95
Weight Score1.87
Normalized Score0.66
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