Byrd Rebecca, Smith Patrick J, McHugh Hannah F, Snyder Laurie D, Pastva Amy M
Department of Cardiology, Duke University Health System, Durham, NC.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC.
Cardiopulm Phys Ther J. 2022 Jan;33(1):24-30. doi: 10.1097/cpt.0000000000000174.
The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation.
Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression.
Participants (N = 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1-3) after hospital discharge. The mean 6MWD of 324 m (SD = 107) improved after rehabilitation to 488 m (SD = 105). Factors associated with improvement were younger age ( = .003), higher baseline forced expiratory volume in 1 second (FEV) ( < .001), and lower baseline 6MWD ( < .001). Participants averaged 22 sessions in 41 days (IQR 35-50); with lower baseline FEV ( = .002) and 6MWD ( < .001) associated with longer completion time.
A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management. ().
本研究旨在评估肺移植出院后立即开始的精简门诊康复计划对6分钟步行距离（6MWD）的影响，并探索6MWD变化及完成康复时间的预测因素。
回顾性收集2009年7月至2019年2月完成基于物理治疗的移植后门诊康复（PTOR）的受者数据。采用重复测量评估康复前至康复后6MWD的变化，采用多元线性回归评估预测因素。
参与者（N = 819，男性占61%，年龄61岁）在出院后2天（四分位间距[IQR] 1 - 3）开始PTOR。康复后，平均6MWD从324 m（标准差 = 107）提高到488 m（标准差 = 105）。与改善相关的因素包括年龄较小（P = .003）、基线第1秒用力呼气量（FEV）较高（P < .001）和基线6MWD较低（P < .001）。参与者在41天内平均接受22次治疗（IQR 35 - 50）；基线FEV较低（P = .002）和6MWD较低（P < .001）与完成时间较长相关。
肺移植后早期的精简门诊康复计划与6MWD的大幅临床意义改善相关。改善的显著预测因素包括年龄、肺功能和起始6MWD。这些来自大量参与PTOR的肺移植受者的研究结果可帮助临床医生制定策略以优化患者管理。（）
