Condensed Outpatient Rehabilitation Early After Lung Transplantation: A Retrospective Analysis of 6-Minute Walk Distance and Its Predictors

R. Byrd, P. Smith, Hannah F. McHugh, L. Snyder, A. Pastva
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引用次数: 4

Abstract

Purpose: The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation. Methods: Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression. Results: Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1–3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age (P = .003), higher baseline forced expiratory volume in 1 second (FEV1) (P < .001), and lower baseline 6MWD (P < .001). Participants averaged 22 sessions in 41 days (IQR 35–50); with lower baseline FEV1 (P = .002) and 6MWD (P < .001) associated with longer completion time. Conclusions: A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management.
肺移植术后早期门诊浓缩康复:6分钟步行距离及其预测因素的回顾性分析
目的:目的是评估出院后立即开始6分钟步行距离(6MWD)的肺移植后门诊浓缩康复计划的效果,并探讨6MWD变化和完成康复时间的预测因素。方法:回顾性收集2009年7月至2019年2月完成基于物理治疗的移植后门诊康复(PTOR)患者的数据。使用重复测量评估6MWD康复前和康复后的变化,并使用多元线性回归评估预测因子。结果:参与者(N = 819, 61%男性,61岁)在出院后2天(四分位数间距[IQR] 1-3)开始PTOR。康复后平均6MWD由324 m (SD = 107)改善至488 m (SD = 105)。与改善相关的因素是年龄更小(P = 0.003), 1秒内基线用力呼气量(FEV1)更高(P < 0.001),基线6MWD更低(P < 0.001)。参与者平均在41天内进行22次治疗(IQR 35-50);较低的基线FEV1 (P = 0.002)和6MWD (P < 0.001)与较长的完井时间相关。结论:肺移植术后早期精简的门诊康复计划与6MWD的显著改善相关,具有临床意义。改善的显著预测因素包括年龄、肺功能和起始6MWD。这些发现来自参与PTOR的大队列肺移植受者,可以帮助临床医生制定优化患者管理的定制策略。
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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