Participation and Progression of Hybrid Rehabilitation following Lung Transplantation

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-05-19 DOI:10.1111/ctr.70185

Rachel Carson, Carina Cordi, Emma Campisi, Skyler Moss, Alyssa Trask, Kevin Zhu, Chaya Gottesman, Manoela Ferreira, Tamires Mori, Lisa Wickerson

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Abstract

Background

Exercise training is recommended to improve physical recovery following lung transplantation (LTx). Since the COVID-19 pandemic, hybrid rehabilitation has emerged utilizing both in-person and home-based exercise. Little is known about exercise participation, progression and intensity with this delivery model.

Methods

A single center retrospective chart review of adult LTx recipients who undertook outpatient rehabilitation within the first 3 months after LTx between December 1, 2022 and February 29, 2024, was conducted. High participation was defined as ≥3 exercise sessions/week for at least 50% of the rehabilitation period. Progression of exercise volumes was examined and walking intensity (Borg leg fatigue scale) was compared between in-person and home rehabilitation.

Results

A total of 166 LTx recipients were included (70% male, 64 [14] years, 71% interstitial lung disease). High rehabilitation participation was observed in 48% of participants over a mean of 8 ± 2 weeks. The median walking distance, biceps and quadriceps resistance training volumes increased between the first and last recorded rehabilitation sessions during both in-person (536 [538] vs. 1073 [650] m, 40 [20] vs. 60 [55] repxlbs, and 20 [10] vs. 40 [30] repxlbs) and home rehabilitation (968 [991] vs. 1556 [1019] m, 50 [70] vs. 100 [70] repxlbs, and 30 [32] vs. 40 [70] repxlbs), all p < 0.05. Leg fatigue was higher during in-person walking compared to home (3 [3–4] vs. 3 [2–3]), p < 0.001.

Conclusions

Half of LTx recipients had low participation in outpatient and home rehabilitation early after transplantation. Understanding barriers to home exercise participation and reporting will enhance hybrid rehabilitation delivery.

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肺移植后混合康复的参与与进展

运动训练被推荐用于改善肺移植术后的身体恢复。自2019冠状病毒病大流行以来，出现了利用面对面和家庭锻炼的混合康复。在这种交付模式下，人们对锻炼的参与、进展和强度知之甚少。方法对2022年12月1日至2024年2月29日LTx术后3个月内门诊康复的成人LTx患者进行单中心回顾性分析。高参与被定义为≥3次/周至少50%的康复期。检查运动量的进展，并比较现场康复和家庭康复的步行强度（博格腿疲劳量表）。结果共纳入166例LTx接受者，其中70%为男性，64岁，71%为间质性肺疾病。在平均8±2周的时间内，48%的参与者有较高的康复参与率。在现场（536 [538]vs. 1073 [650] m, 40 [20] vs. 60 [55] repxlbs, 20 [10] vs. 40 [30] repxlbs）和家庭康复（968 [991]vs. 1556 [1019] m, 50 [70] vs. 100 [70] repxlbs, 30 [32] vs. 40 [70] repxlbs）期间，第一次和最后一次记录的康复疗程之间的中位步行距离、二头肌和股四头肌阻力训练量均有所增加。0.05. 与在家相比，步行时腿部疲劳程度更高（3[3 - 4]与3 [2-3]），p <；0.001. 结论半数LTx受者移植后早期门诊和家庭康复参与度较低。了解家庭运动参与和报告的障碍将加强混合康复交付。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.