Supervisors info:
Καρατζάνος Ελευθέριος, Επιστημονικός Συνεργάτης, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Ρούτση Χριστίνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ροβίνα Νικολέττα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
INTRODUCTION: Lung transplantation is the final treatment option for people with end-stage respiratory disease. Dyspnea, limited exercise capacity and reduced quality of life are common features of respiratory patients undergoing lung transplantation. However, lung transplant recipients continue to experience exercise difficulty and poor quality of life for several years after transplantation. Studies have shown that exercise rehabilitation programs can help improve many parameters and it is important to implement them before and after transplantation.
OBJECTIVES: The aim of this systematic review was to investigate the effect of exercise postoperatively in patients undergoing lung transplantation.
METHODS: A search of the literature of studies published up to 2020, in English was performed in the PubMed, CINAHL and SCOPUS databases using relevant search terms. The study population consisted of adult recipients after lung transplantation who underwent a postoperative rehabilitation program.
RESULTS: Eleven studies (5 RCTs, 3 cohort and 3 single-arm pilot studies) were included, evaluating the effects of PR in 1072 patients after lung transplantation. The median sample size was 34 participants (range 4 to 722 participants). The median age of participants was 54.9 years. Patients of both genders were included, while 46% of the participants were women. In all studies participants followed an exercise rehabilitation programme, with the exception of the control group in one study who did not exercise. In the majority of studies, the intervention involved a combination of aerobic exercise and strengthening exercises. The median duration of the rehabilitation programs was 6 weeks (range 3 to 24 weeks). The frequency of the sessions varied from 1 to 7 times per week. The mean score for the 5 RCTs was 6 (range 5 to 8), indicating moderate methodological quality. In the majority of studies, aerobic exercise combined with resistance exercises improved exercise capacity, muscle strength, quality of life and respiratory function in the recipients.
CONCLUSIONS: Exercise has a positive effect on patients after lung transplantation. Improvements in exercise capacity, muscle strength, quality of life and respiratory function indicate the importance of physical rehabilitation for these patients. However, further research, with studies of high methodological quality, is needed to confirm and strengthen these findings. In addition, examination of other parameters, such as survival, hospital length of stay, rejection, hospital readmissions, is important to fully understand the benefits of exercise in this patient group.
Keywords:
Lung transplant, Exercise, Rehabilitation, Physical activity, Training
