What Happens to Frailty in the First Year after Lung Transplantation?
| Autor: | Helen Whitford, R. Robinson, Ranjana Steward, L.M. Fuller, M. Poulsen, G.M. Snell, W.Y. Shi, Y. Cristiano |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty COPD Rehabilitation Strength training business.industry Walk distance medicine.medical_treatment medicine.disease Grip strength Rehabilitation exercise Internal medicine medicine Lung transplantation Surgery Treadmill Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 38:S197 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2019.01.478 |
| Popis: | Purpose Frailty is prevalent in lung transplant (LTX) candidates. Frailty can be associated with death before and after LTX, it is unclear if frailty trajectory persists for the first year. The study aimed to investigate frailty over the first year of LTX. Methods LTX candidates aged over 18 years were consented at listing time. All post LTX recipients completed thrice weekly, 12 week exercise rehabilitation program consisting of cardiovascular training on bike and treadmill and upper and lower limb strength training. Clinical data was collected. Edmonton frail scale (EFS) was used to assess frailty. Grip strength was also tested. Primary outcome was 6minute walk distance (6MWD) measured at 4 time-points: pre LTX, pre-rehabilitation, post-rehabilitation and 1 year. Results Of 103 participants, 90 (87%) were transplanted. Mean age was 58±11 yrs, 48 % were male, 52% had primary diagnosis of COPD. Frailty scores pre LTX were mean 5.54 ± 2.4 and at one year mean 3.28 ±1.5. Amongst all participants, 6WMD improved significantly over time: pre-rehabilitation (mean 326m) compared to post-rehabilitation (mean 523m (p 8 had shorter 6MWD preLTX compared to those with EFS ≤ 8 (245m vs. 305m, p=0.085) and similarly at pre-rehabilitation (277m vs. 331m, p=0.077). There were no differences in 6MWD comparing EFS > 8 vs ≤ 8 post-rehabilitation (523m vs. 520m, p=0.93) or at 1 year (497m vs. 510m, p=0.80). Participants with poorer EFS functional performance domain had shorter 6MWD pre LTX and pre-rehabilitation, but this difference disappeared by 1 year. Those with baseline grip strength Conclusion Participants in a structured post-LTX rehabilitation program improved in functional exercise capacity (6MWD). The program improves 6MWD in frail patients to a point comparable to less frail patients, with poor pre-rehabilitation functional capacity being successfully managed during the program. Grip strength may serve as an important predictor of the trajectory of improvement. |
| Databáze: | OpenAIRE |
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