Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Heart Lung Transplant. 2013 Jun;32(6):626-32. doi: 10.1016/j.healun.2013.04.002.
While awaiting lung transplantation, candidates may participate in pulmonary rehabilitation to improve their fitness for surgery. However, pulmonary rehabilitation outcomes have not been systematically evaluated in lung transplant candidates.
This investigation was a retrospective cohort study of 345 pre-transplant pulmonary rehabilitation participants who received a lung transplant between January 2004 and June 2009 and had available pre-transplant exercise data. Data extracted included: 6-minute walk tests at standard intervals; exercise training details; health-related quality-of-life (HRQL) measures; and early post-transplant outcomes. Paired t-tests were used to examine changes in the 6MW distance (6MWD), exercise training volume and HRQL during the pre-transplant period. We evaluated the association between pre-transplant 6MWD and transplant hospitalization outcomes.
The final 6MWD prior to transplantation was only 15 m less than the listing 6MWD (n = 200; p = 0.002). Exercise training volumes increased slightly from the start of the pulmonary rehabilitation program until transplant: treadmill, increase 0.69 ml/kg/min (n = 238; p < 0.0001); biceps resistance training, 18 lbs. × reps (n = 286; p < 0.0001); and quadriceps resistance training, 15 lbs. × reps (n = 278; p < 0.0001). HRQL measures declined. A greater final 6MWD prior to transplant correlated with a shorter length of stay in the hospital (n = 207; p = 0.003).
Exercise capacity and training volumes are well preserved among lung transplant candidates participating in pulmonary rehabilitation, even in the setting of severe, progressive lung disease. Participants with greater exercise capacity prior to transplantation have more favorable early post-transplant outcomes.
在等待肺移植期间，候选者可能会参加肺康复治疗，以提高手术适应性。然而，肺移植候选者的肺康复治疗结果尚未得到系统评估。
本研究是一项回顾性队列研究，纳入了 345 名在 2004 年 1 月至 2009 年 6 月期间接受肺移植且有术前运动数据的肺康复参与者。提取的数据包括：标准间隔的 6 分钟步行测试；运动训练细节；健康相关生活质量（HRQL）测量；以及早期移植后结果。采用配对 t 检验比较了移植前的 6MWD（6MWD）、运动训练量和 HRQL 的变化。评估了移植前 6MWD 与移植住院结果之间的关联。
移植前的最终 6MWD 仅比列入名单的 6MWD 少 15 米（n=200；p=0.002）。运动训练量从肺康复项目开始到移植时略有增加：跑步机，增加 0.69 ml/kg/min（n=238；p<0.0001）；二头肌阻力训练，18 磅×重复（n=286；p<0.0001）；和四头肌阻力训练，15 磅×重复（n=278；p<0.0001）。HRQL 测量值下降。移植前更大的最终 6MWD 与住院时间较短相关（n=207；p=0.003）。
即使在严重、进行性肺部疾病的情况下，参加肺康复的肺移植候选者的运动能力和训练量仍保持良好。移植前运动能力更强的参与者有更有利的早期移植后结果。
