Lung Transplant Program, University Health Network, Toronto, Ontario, Canada.
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.
Clin Transplant. 2020 Dec;34(12):e14095. doi: 10.1111/ctr.14095. Epub 2020 Oct 19.
To evaluate whether the short physical performance battery (SPPB) pre-lung transplant (LTx) was responsive to pre-habilitation and predicted pre- and early post-transplant outcomes.
A retrospective study of LTx candidates accepted for transplant between 2016 and 2017. SPPB was categorized as frail/pre-frail (≤9/12) and non-frail (≥10/12).
150 patients had LTx assessment SPPB data (53% male, 61 [52-67] years, 59% had interstitial lung disease (ILD), 26% frail/pre-frail). 131 (87%) underwent transplant by December 31, 2018. Adjusting for age, sex, diagnosis and Canadian transplant listing urgency, and frailty/pre-frailty at LTx assessment was associated with a lower 6MWD pre-transplant [-89 meters 95%CI (-125 to -53), P < .0001]. 62 patients underwent six weeks of pre-habilitation. SPPB increased (11 [10-12) vs. 12 [11-12], P = .01) reflected in the chair stand component (11.4 ± 4.4 vs. 9.8 ± 2.8 seconds, P = .007), with larger improvements in the frail/pre-frail group. A frail/pre-frail SPPB closest to the time of transplant was associated with a lower 6MWD [-77 m 95%CI (-128 to -25), P = .004] but not with hospital length of stay or gait aid use three months post-transplant.
Frailty/pre-frailty was associated with a decreased 6MWD pre- and post-transplant. The SPPB increased following pre-habilitation, which may reflect increased lower extremity strength.
评估短期体能表现电池（SPPB）在肺移植（LTx）前是否对预适应有反应，并预测移植前和早期移植后的结果。
对 2016 年至 2017 年间接受移植的 LTx 候选者进行回顾性研究。SPPB 分为虚弱/虚弱前（≤9/12）和非虚弱（≥10/12）。
150 名患者有 LTx 评估 SPPB 数据（53%为男性，61 [52-67] 岁，59%患有间质性肺病（ILD），26%为虚弱/虚弱前）。131 人（87%）于 2018 年 12 月 31 日前接受了移植。调整年龄、性别、诊断和加拿大移植清单紧急情况以及 LTx 评估时的虚弱/虚弱前状态与移植前较低的 6MWD 相关[-89 米 95%CI（-125 至-53），P<0.0001]。62 名患者接受了六周的预适应治疗。SPPB 增加（11 [10-12] 比 12 [11-12]，P=0.01），反映在椅子站立部分（11.4±4.4 秒比 9.8±2.8 秒，P=0.007），虚弱/虚弱前组的改善更大。与移植时间最接近的虚弱/虚弱前 SPPB 与较低的 6MWD 相关[-77 m 95%CI（-128 至-25），P=0.004]，但与移植后三个月的住院时间或步态辅助使用无关。
虚弱/虚弱前与移植前后的 6MWD 降低有关。SPPB 在预适应后增加，这可能反映出下肢力量的增加。
