Abidi Yafet, Kovats Zsuzsanna, Bohacs Aniko, Fekete Monika, Naas Saoussen, Madurka Ildiko, Torok Klara, Bogyo Levente, Varga Janos Tamas
Department of Pulmonology, Semmelweis University, 1083 Budapest, Hungary.
Department of Public Health, Faculty of Medicine, Semmelweis University, 1083 Budapest, Hungary.
Life (Basel). 2023 Feb 11;13(2):506. doi: 10.3390/life13020506.
Both lung transplant recipients and candidates are characterised by reduced training capacity and low average quality of life (QoL). This review investigates the impact of training on exercise ability and QoL in patients before and after lung transplant.
Searches were conducted from the beginning to 7 March 2022 using the terms "exercise," "rehabilitation," "lung transplant," "exercise ability," "survival," "quality of life" and "telerehabilitation" in six databases, including Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL, Nursing and Allied Health, and Scopus. The inclusion criteria were studies evaluating the effects of an exercise training programme concurrent with lung transplantation as well as patients and candidates (>18 years old) through any lung diseases. The term "lung transplant rehabilitation" was used to refer to all carefully thought-out physical activities with the ultimate or intermediate objective of improving or maintaining physical health.
Out of 1422 articles, 10 clinical- and 3 telerehabilitation studies, candidates (n = 420) and recipients (n = 116) were related to the criteria and included in this review. The main outcome significantly improved in all studies. The 6-min walk distance, maximum exercise capacity, peak oxygen uptake, or endurance for constant load rate cycling improved measuring physical activity [aerobic exercises, breathing training, and aerobic and inspiratory muscle training sessions (IMT)]. Overall scores for dyspnoea improved after exercise training. Furthermore, health-related quality of life (HRQOL) also improved after aerobic exercise training, which was performed unsupervised or accompanied by breathing sessions. Aerobic training alone rather than combined with inspiratory muscle- (IMT) or breathing training enhanced exercise capacity.
In conclusion, rehabilitation programmes seem to be beneficial to patients both preceding and following lung transplantation. More studies are required to determine the best training settings in terms of time scale, frequency, and work intensity in terms of improving exercise ability, dyspnoea, and HRQOL.
肺移植受者和候选者均表现为训练能力下降和平均生活质量(QoL)较低。本综述调查了训练对肺移植患者移植前后运动能力和生活质量的影响。
于2022年3月7日前,在六个数据库中进行检索,检索词为“运动”“康复”“肺移植”“运动能力”“生存率”“生活质量”和“远程康复”,这些数据库包括Cochrane对照试验中心注册库(CENTRAL)、PubMed、护理学与健康领域数据库(CINAHL)、护理学与联合健康数据库以及Scopus数据库。纳入标准为评估与肺移植同时进行的运动训练计划对患者和候选者(年龄>18岁)通过任何肺部疾病产生的影响的研究。术语“肺移植康复”用于指代所有经过精心设计的体育活动,其最终或中间目标是改善或维持身体健康。
在1422篇文章中,有10项临床研究和3项远程康复研究,候选者(n = 420)和受者(n = 116)符合标准并纳入本综述。所有研究的主要结果均有显著改善。6分钟步行距离、最大运动能力、峰值摄氧量或恒定负荷率骑行耐力均有所提高,以此衡量身体活动[有氧运动、呼吸训练以及有氧和吸气肌训练课程(IMT)]。运动训练后呼吸困难的总体评分有所改善。此外,在无监督或伴有呼吸课程的有氧运动训练后,健康相关生活质量(HRQOL)也有所提高。单独的有氧运动训练而非与吸气肌训练(IMT)或呼吸训练相结合可增强运动能力。
总之,康复计划似乎对肺移植前后的患者均有益。需要更多研究来确定在改善运动能力、呼吸困难和健康相关生活质量方面,在时间尺度、频率和工作强度方面的最佳训练设置。