Exercise Training for Adult Lung Transplant Recipients

Gutierrez-Arias R, Martinez-Zapata MJ, Gaete-Mahn MC, Osorio D, Bustos L, Melo Tanner J, Hidalgo R, SeronP. Exercise training for adult lung transplant recipients. Cochrane Database of Systematic Reviews 2021, No. 7. Art. No.: CD012307. doi: 10.1002 /14651858.CD012307.pub2. Accessed July 28, 2021.

Commentary

This study will measure maximal, functional exercise capacity to determine the benefits and safety of exercise training in adult lung transplant recipients.

The primary results included 8 RCTs (438 participants) with a median sample size of 60 participants, range of 16 to 83 participants, mean age of participants was 54.9 years, and 51.9% of participants were male.

・The median duration of the exercise training program in the group that received the intervention was 13 weeks, and the median duration of training in the active control group was 4 weeks.

Overall, the risk of bias was considered high. The reason for this is that the study participants could not be blinded and the results were reported selectively.

・In two studies that compared resistance exercise training with no exercise, increases in muscle strength and bone mineral density were reported with exercise training, but there was no difference in adverse events.

Exercise capacity, health-related quality of life (HRQoL), respiratory function, and death (from any cause) were not reported.

・Three studies compared two different strength training programs, and two studies that compared squatting with a vibrating platform (WBVT) to floor squatting reported improvements in the 6-minute walk test (6MWT).

The supervised upper extremity exercise (SULP) program improved the 6MWT at 6 months compared to unmonitored upper extremity exercise (NULP); there were no differences in HRQoL, adverse events, muscle strength, or death (from any cause); respiratory function and pathological fractures were not reported.

・Two studies comparing multimodal exercise training versus no exercise reported an improvement of 6MWT in muscle strength, maximal leg press, 3 and 12 months after implantation.

・One study that compared the same multimodal exercise program given over 7 and 14 weeks reported no difference in 6MWT, HRQoL, adverse events, respiratory function, muscle strength, or death (any cause). No pathological fractures have been reported.

The authors concluded that

The evidence on the effects of exercise training is very uncertain with respect to maximal, functional exercise capacity, HRQoL, and safety, with very imprecise effect estimates and high risk of bias in adults who have undergone lung transplantation.