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This thesis focusses on the level of physical activity after solid organ transplantation and factors associated with this level. Functional recovery after transplantation is not as good as expected. However, higher levels of physical activity after transplantation are associated with better outcomes. This thesis showed that less than 60% of transplant recipients complied to the physical activity guidelines. A higher level of physical activity was associated with better survival after kidney transplantation, independent of cardiac damage. Cardiac damage was, however, a intermediate step in the association. Peripheral muscle strength showed to be an important predictor of exercise capacity after lung transplantation, interventions around six months after transplantation are needed to improve exercise capacity. Qualitative and quantitative studies into barriers and motivators to physical activity after transplantation showed that most factors are comparable to those in the general population. Specific factors for transplant recipients were care for the new organ, medication side-effects, and expertise of personnel. In intervention development physical limitation, fear of negative effects, low expectations and self-confidence, and exercise self-efficacy should be taken into account. During an expedition to Mount Kilimanjaro the tolerance to strenuous physical activity after transplantation was studied; this was comparable for carefully selected recipients and controls. Despite of the large variety in physical activity level after transplantation a substantial part of recipients do not fulfill the physical activity guidelines. These results stress the need for interventions. Not the type of transplantation but the experienced barriers, motivators, and psychological factors should be leading. |
