Rehabilitation in Patients before and after Lung Transplantation.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.