Lisa Wickerson1,2, Dmitry Rozenberg1,3, Chaya Gottesman1,2, Denise Helm1,2, Sunita Mathur2, Lianne G Singer1,3. 1. Lung Transplant Program, University Health Network, Toronto, Ontario, Canada. 2. Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada. 3. Department of Medicine, Respirology, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: To evaluate whether the short physical performance battery (SPPB) pre-lung transplant (LTx) was responsive to pre-habilitation and predicted pre- and early post-transplant outcomes. METHODS: A retrospective study of LTx candidates accepted for transplant between 2016 and 2017. SPPB was categorized as frail/pre-frail (≤9/12) and non-frail (≥10/12). RESULTS: 150 patients had LTx assessment SPPB data (53% male, 61 [52-67] years, 59% had interstitial lung disease (ILD), 26% frail/pre-frail). 131 (87%) underwent transplant by December 31, 2018. Adjusting for age, sex, diagnosis and Canadian transplant listing urgency, and frailty/pre-frailty at LTx assessment was associated with a lower 6MWD pre-transplant [-89 meters 95%CI (-125 to -53), P < .0001]. 62 patients underwent six weeks of pre-habilitation. SPPB increased (11 [10-12) vs. 12 [11-12], P = .01) reflected in the chair stand component (11.4 ± 4.4 vs. 9.8 ± 2.8 seconds, P = .007), with larger improvements in the frail/pre-frail group. A frail/pre-frail SPPB closest to the time of transplant was associated with a lower 6MWD [-77 m 95%CI (-128 to -25), P = .004] but not with hospital length of stay or gait aid use three months post-transplant. CONCLUSIONS: Frailty/pre-frailty was associated with a decreased 6MWD pre- and post-transplant. The SPPB increased following pre-habilitation, which may reflect increased lower extremity strength.
PURPOSE: To evaluate whether the short physical performance battery (SPPB) pre-lung transplant (LTx) was responsive to pre-habilitation and predicted pre- and early post-transplant outcomes. METHODS: A retrospective study of LTx candidates accepted for transplant between 2016 and 2017. SPPB was categorized as frail/pre-frail (≤9/12) and non-frail (≥10/12). RESULTS: 150 patients had LTx assessment SPPB data (53% male, 61 [52-67] years, 59% had interstitial lung disease (ILD), 26% frail/pre-frail). 131 (87%) underwent transplant by December 31, 2018. Adjusting for age, sex, diagnosis and Canadian transplant listing urgency, and frailty/pre-frailty at LTx assessment was associated with a lower 6MWD pre-transplant [-89 meters 95%CI (-125 to -53), P < .0001]. 62 patients underwent six weeks of pre-habilitation. SPPB increased (11 [10-12) vs. 12 [11-12], P = .01) reflected in the chair stand component (11.4 ± 4.4 vs. 9.8 ± 2.8 seconds, P = .007), with larger improvements in the frail/pre-frail group. A frail/pre-frail SPPB closest to the time of transplant was associated with a lower 6MWD [-77 m 95%CI (-128 to -25), P = .004] but not with hospital length of stay or gait aid use three months post-transplant. CONCLUSIONS: Frailty/pre-frailty was associated with a decreased 6MWD pre- and post-transplant. The SPPB increased following pre-habilitation, which may reflect increased lower extremity strength.
Authors: Manoela de Paula Ferreira; Noori Chowdhury; Lisa Wickerson; Heather Ross; Nazia Selzner; S Joseph Kim; Lianne G Singer; Sunita Mathur Journal: Int J Telerehabil Date: 2022-06-03
Authors: Nicholas Bourgeois; Shirin M Shallwani; Fahad S Al-Huda; Sunita Mathur; Charles Poirier; Tania Janaudis-Ferreira Journal: Transplant Direct Date: 2022-10-07