Lisa Wickerson1, Sunita Mathur2, Lianne G Singer3, Dina Brooks4. 1. L. Wickerson, BScPT, MSc, PhD(c), Toronto Lung Transplant Program, University Health Network, 200 Elizabeth St, 4EC-305, Toronto, Ontario, Canada M5G 2C4, and Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada. lisa.wickerson@utoronto.ca. 2. S. Mathur, BScPT, MSc, PhD, Department of Physical Therapy, University of Toronto. 3. L.G. Singer, MD, Toronto Lung Transplant Program, University Health Network, and Department of Medicine, University of Toronto. 4. D. Brooks, BScPT, MSc, PhD, Department of Physical Therapy, University of Toronto.
Abstract
BACKGROUND: Little is known of the early changes in physical activity after lung transplantation. OBJECTIVES: The purposes of this study were: (1) to describe physical activity levels in patients up to 6 months following lung transplantation and (2) to explore predictors of the change in physical activity in that population. DESIGN: This was a prospective cohort study. METHODS: Physical activity (daily steps and time spent in moderate-intensity activity) was measured using an accelerometer before and after transplantation (at hospital discharge, 3 months, and 6 months). Additional functional measurements included submaximal exercise capacity (measured with the 6-Minute Walk Test), quadriceps muscle torque, and health-related quality of life (measured with the Medical Outcomes Study 36-Item Short-Form Health Survey 36 [SF-36] and the St George's Respiratory Questionnaire). RESULTS: Thirty-six lung transplant recipients (18 men, 18 women; mean age=49 years, SD=14) completed posttransplant measurements. Before transplant, daily steps were less than a third of the general population. By 3 months posttransplant, the largest improvement in physical activity had occurred, and level of daily steps reached 55% of the general population. The change in daily steps (pretransplant to 3 months posttransplant) was inversely correlated with pretransplant 6-minute walk distance (r=-.48, P=.007), daily steps (r=-.36, P=.05), and SF-36 physical functioning (SF-36 PF) score (r=-.59, P=.0005). The SF-36 PF was a significant predictor of the change in physical activity, accounting for 35% of the variation in change in daily steps. LIMITATIONS: Only individuals who were ambulatory prior to transplant and discharged from the hospital in less than 3 months were included in the study. CONCLUSIONS: Physical activity levels improve following lung transplantation, particularly in individuals with low self-reported physical functioning. However, the majority of lung transplant recipients remain sedentary between 3 to 6 months following transplant. The role of exercise training, education, and counseling in further improving physical activity levels in lung transplant recipients should be further explored.
BACKGROUND: Little is known of the early changes in physical activity after lung transplantation. OBJECTIVES: The purposes of this study were: (1) to describe physical activity levels in patients up to 6 months following lung transplantation and (2) to explore predictors of the change in physical activity in that population. DESIGN: This was a prospective cohort study. METHODS: Physical activity (daily steps and time spent in moderate-intensity activity) was measured using an accelerometer before and after transplantation (at hospital discharge, 3 months, and 6 months). Additional functional measurements included submaximal exercise capacity (measured with the 6-Minute Walk Test), quadriceps muscle torque, and health-related quality of life (measured with the Medical Outcomes Study 36-Item Short-Form Health Survey 36 [SF-36] and the St George's Respiratory Questionnaire). RESULTS: Thirty-six lung transplant recipients (18 men, 18 women; mean age=49 years, SD=14) completed posttransplant measurements. Before transplant, daily steps were less than a third of the general population. By 3 months posttransplant, the largest improvement in physical activity had occurred, and level of daily steps reached 55% of the general population. The change in daily steps (pretransplant to 3 months posttransplant) was inversely correlated with pretransplant 6-minute walk distance (r=-.48, P=.007), daily steps (r=-.36, P=.05), and SF-36 physical functioning (SF-36 PF) score (r=-.59, P=.0005). The SF-36 PF was a significant predictor of the change in physical activity, accounting for 35% of the variation in change in daily steps. LIMITATIONS: Only individuals who were ambulatory prior to transplant and discharged from the hospital in less than 3 months were included in the study. CONCLUSIONS: Physical activity levels improve following lung transplantation, particularly in individuals with low self-reported physical functioning. However, the majority of lung transplant recipients remain sedentary between 3 to 6 months following transplant. The role of exercise training, education, and counseling in further improving physical activity levels in lung transplant recipients should be further explored.
Authors: Jon Kobashigawa; Darshana Dadhania; Sangeeta Bhorade; Deborah Adey; Joseph Berger; Geetha Bhat; Marie Budev; Andres Duarte-Rojo; Michael Dunn; Shelley Hall; Meera N Harhay; Kirsten L Johansen; Susan Joseph; Cassie C Kennedy; Evan Kransdorf; Krista L Lentine; Raymond J Lynch; Mara McAdams-DeMarco; Shunji Nagai; Michael Olymbios; Jignesh Patel; Sean Pinney; Joanna Schaenman; Dorry L Segev; Palak Shah; Lianne G Singer; Jonathan P Singer; Christopher Sonnenday; Puneeta Tandon; Elliot Tapper; Stefan G Tullius; Michael Wilson; Martin Zamora; Jennifer C Lai Journal: Am J Transplant Date: 2018-12-22 Impact factor: 8.086
Authors: Lisa Wickerson; Dmitry Rozenberg; Tania Janaudis-Ferreira; Robin Deliva; Vincent Lo; Gary Beauchamp; Denise Helm; Chaya Gottesman; Polyana Mendes; Luciana Vieira; Margaret Herridge; Lianne G Singer; Sunita Mathur Journal: World J Transplant Date: 2016-09-24
Authors: Ruud H Knols; Nicolas Fischer; Dario Kohlbrenner; Anastasios Manettas; Eling D de Bruin Journal: Front Physiol Date: 2018-07-20 Impact factor: 4.566
Authors: James A Blumenthal; Patrick J Smith; Andrew Sherwood; Stephanie Mabe; Laurie Snyder; Courtney Frankel; Daphne C McKee; Natalie Hamilton; Francis J Keefe; Sheila Shearer; Jeanne Schwartz; Scott Palmer Journal: Transplant Direct Date: 2020-02-18