Tania Janaudis-Ferreira1,2,3,4, Sunita Mathur4,5, Robin Deliva5,6,7, Nancy Howes8, Catherine Patterson5,6,7, Agnès Räkel9,4, Stephanie So5,6,7, Lisa Wickerson10, Michel White11, Yaron Avitzur12, Olwyn Johnston13, Norine Heywood14, Sunita Singh15, Sandra Holdsworth4. 1. School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada. 2. Translational Research in Respiratory Diseases program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada. 3. Respiratory Epidemiology and Clinical Research Unit, Research Institute, McGill University Health Center, Montreal, QC, Canada. 4. Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada. 5. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada. 6. Rehabilitation Services, The Hospital for Sick Children, Toronto, ON, Canada. 7. Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, Canada. 8. Department of Physical Therapy, London Health Sciences Centre, London, ON, Canada. 9. Division of Endocrinology, Department of Medicine, University of Montreal Hospital Center, Montreal, QC, Canada. 10. Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada. 11. Department of Medicine, University of Montreal, Montreal, QC, Canada. 12. Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada. 13. Kidney and Pancreas Transplant Program, Vancouver General Hospital, Vancouver, BC, Canada. 14. Royal Victoria Hospital, McGill University Health Centre, Montreal, QC, Canada. 15. Kidney Transplant Program, University Health Network, Toronto, ON, Canada.
Abstract
BACKGROUND: The objectives of this position statement were to provide evidence-based and expert-informed recommendations for exercise training in adult and children solid organ transplant (SOT) candidates and recipients and on the outcomes relevant to exercise training and physical function that should be evaluated in SOT. METHODS: We identified randomized controlled trials (RCTs) and systematic reviews of exercise interventions in adult and pediatric SOT candidates and recipients. When RCTs were not available, studies of any design were reviewed. The key recommendations were based on scientific evidence and expert-informed opinion. RESULTS: We recommended that exercise training should be offered in the pre- and posttransplant phase for both adults and children. In adults, exercise training pretransplant was safe, but there was insufficient evidence to provide specific guidelines on the training characteristics. RCTs in adult SOT recipients demonstrated that exercise training improved exercise capacity, lower extremity muscle strength, and health-related quality of life. To obtain benefits, exercise training should be of moderate to vigorous-intensity level, 3-5 times a week for a minimum of 8 weeks. In pediatrics, there is an urgent need for high-quality multicenter clinical trials in the pre- and posttransplant phases. Due to limited evidence, specific recommendations regarding training characteristics could not be provided for pediatrics. CONCLUSIONS: The clinical relevance of this position statement is that it provides a key step toward raising awareness of the importance of exercise training in SOT patients among transplant professionals. It also identifies key areas for further research.
BACKGROUND: The objectives of this position statement were to provide evidence-based and expert-informed recommendations for exercise training in adult and children solid organ transplant (SOT) candidates and recipients and on the outcomes relevant to exercise training and physical function that should be evaluated in SOT. METHODS: We identified randomized controlled trials (RCTs) and systematic reviews of exercise interventions in adult and pediatric SOT candidates and recipients. When RCTs were not available, studies of any design were reviewed. The key recommendations were based on scientific evidence and expert-informed opinion. RESULTS: We recommended that exercise training should be offered in the pre- and posttransplant phase for both adults and children. In adults, exercise training pretransplant was safe, but there was insufficient evidence to provide specific guidelines on the training characteristics. RCTs in adult SOT recipients demonstrated that exercise training improved exercise capacity, lower extremity muscle strength, and health-related quality of life. To obtain benefits, exercise training should be of moderate to vigorous-intensity level, 3-5 times a week for a minimum of 8 weeks. In pediatrics, there is an urgent need for high-quality multicenter clinical trials in the pre- and posttransplant phases. Due to limited evidence, specific recommendations regarding training characteristics could not be provided for pediatrics. CONCLUSIONS: The clinical relevance of this position statement is that it provides a key step toward raising awareness of the importance of exercise training in SOT patients among transplant professionals. It also identifies key areas for further research.
Authors: Jennifer C Lai; Jennifer L Dodge; Matthew R Kappus; Randi Wong; Yara Mohamad; Dorry L Segev; Mara McAdams-DeMarco Journal: Am J Gastroenterol Date: 2021-04 Impact factor: 10.864
Authors: Oyuntugs Byambasukh; Maryse C J Osté; António W Gomes-Neto; Else van den Berg; Gerjan Navis; Stephan J L Bakker; Eva Corpeleijn Journal: J Clin Med Date: 2020-02-03 Impact factor: 4.241
Authors: Paula A B Ribeiro; Mathieu Gradassi; Sarah-Maude Martin; Jonathan Leenknegt; Mathilde Baudet; VyVan Le; Marie-Pascale Pomey; Agnes Räkel; François Tournoux Journal: Arq Bras Cardiol Date: 2022-08 Impact factor: 2.667
Authors: Nicholas Bourgeois; Shirin M Shallwani; Fahad S Al-Huda; Sunita Mathur; Charles Poirier; Tania Janaudis-Ferreira Journal: Transplant Direct Date: 2022-10-07