Exercise training after lung transplantation: A systematic review
published online 05 February 2010.
Background
Lung transplant recipients experience persistent impairments in exercise capacity and skeletal muscle function despite a vast improvement in lung function after transplantation. Exercise training may be beneficial in improving exercise capacity in lung transplant recipients. A systematic review was undertaken to examine the evidence for exercise training on functional outcomes in lung transplant recipients.
Methods
Studies were identified by searching electronic databases and scanning reference lists. Only randomized controlled trials, controlled trials, and prospective cohorts were included in the review. Seven studies met the inclusion criteria. Study quality was assessed using the Physiotherapy Evidence Database, Jadad, and Downs scales.
Results
The overall quality of studies was fair to moderate in assessing the effect of exercise training on maximal and functional exercise capacity, skeletal muscle function, and lumbar bone mineral density. Every study reported significant improvements in these outcomes. Some studies lacked randomization and/or a control group, so it was not possible to separate the effects of training with the natural recovery process after lung transplantation.
Conclusion
Some evidence was found to support that a period of structured exercise training could improve maximal and functional exercise capacity, skeletal muscle strength, and lumbar bone mineral density in lung transplant recipients. Further studies are needed to determine the potential for exercise training to optimize these functional outcomes and to develop optimal guidelines for exercise prescription in the lung transplant population.
aDepartment of Rehabilitation Services, University Health Network, Toronto, Ontario, Canada
bDepartment of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
cRespiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
Reprint requests: Lisa Wickerson, Department of Rehabilitation Services, University Health Network, 200 Elizabeth St, Toronto, ON M5G 2C4. Telephone: 416 340 3800 ext 3982. Fax: 416 977 1467
ABSTRACT