Lung transplant patients who participated in an exercise training program immediately after hospital discharge had improved physical fitness and quality of life, compared with patients who did not, according to the results of a randomized trial.
Lung transplant patients who took part in a three-month structured exercise program immediately after hospital discharge improved their health-related quality of life and reduced their risk of cardiovascular problems. These findings were published in the June American Journal of Transplantation.
The Need for Exercise
“People who have received lung transplants often have weak muscles and limited endurance due to their sedentary lifestyle before their transplant and the drugs they need to take after surgery,” explained lead author Daniel Langer, PT, PhD, from the University of Leuven in Belguim.
Recent research by the authors showed that transplant patients often remain inactive after surgery. As many as half also develop illnesses such as osteoporosis, high cholesterol, and diabetes, with around 90% developing high blood pressure. It is well known that these health problems can be prevented by a physically active lifestyle.
“We were keen to explore whether an exercise training intervention would be capable of partially reversing these remaining limitations in muscle function, enabling patients to improve exercise capacity and increase their participation in daily activities.”
Forty patients with no complications after single or double lung transplants were randomized to a three-month exercise initiative (n = 21) or to a control intervention (n = 19). Demographics for both groups (average age, 59) were similar.
Patients in the intervention group participated in supervised exercise three times a week with each session lasting about 90 minutes. The training included cycling, walking, stair climbing, and resistance exercise using leg press equipment. Exercise intensity increased during the three-month training program.
The control group did not take part in the training regimen. However, all the patients took part in daily mobility exercises in hospital after surgery for an average of six weeks, which included walking, cycling, stair climbing, and resistance exercises.
The investigators compared daily walking, physical fitness, quality of life, and ill health from cardiovascular disease between the two groups. This included monitoring their blood pressure during normal activities over a 24-hour period.
One year after hospital discharge, 18 patients remained in the intervention group, with 16 in the control group (five patients were lost due to severe medical complications and one was unwilling to continue). With regard to minutes of daily walking time (the primary outcome), patients in the intervention group were walking an average of 85 minutes a day, while patients in the control group were walking an average of 54 minutes a day.
Quadriceps muscle force, six-minute walk distance, and self-reported physical functioning were significantly higher and average 24-hour diastolic and systolic blood pressure were significantly lower in treated patients.
“We believe that this research underlines the considerable benefits of structured exercise program following uncomplicated lung transplant surgery,” the study authors noted.
Lander D, Burtin C, Schepers L, et al. Exercise training after lung transplantation improves participation in daily activity: a randomized controlled trial. Am J Transplant. 2012;12(6):1584-1592.