Exercise for Solid Organ Transplant Candidates and Recipients: A Joint Position Statement of the Canadian Society of Transplantation and CAN-RESTORE

被引:59
作者
Janaudis-Ferreira, Tania [1 ,2 ,3 ,4 ]
Mathur, Sunita [4 ,5 ]
Deliva, Robin [5 ,6 ,7 ]
Howes, Nancy [8 ]
Patterson, Catherine [5 ,6 ,7 ]
Rakel, Agnes [4 ,9 ]
So, Stephanie [5 ,6 ,7 ]
Wickerson, Lisa [10 ]
White, Michel [11 ]
Avitzur, Yaron [12 ]
Johnston, Olwyn [13 ]
Heywood, Norine [14 ]
Singh, Sunita [15 ]
Holdsworth, Sandra [4 ]
机构
[1] McGill Univ, Sch Phys & Occupat Therapy, Montreal, PQ, Canada
[2] McGill Univ, Translat Res Resp Dis Program, Res Inst, Hlth Ctr, Montreal, PQ, Canada
[3] McGill Univ, Res Inst, Resp Epidemiol & Clin Res Unit, Hlth Ctr, Montreal, PQ, Canada
[4] Canadian Donat & Transplantat Res Program, Edmonton, AB, Canada
[5] Univ Toronto, Dept Phys Therapy, Toronto, ON, Canada
[6] Hosp Sick Children, Rehabil Serv, Toronto, ON, Canada
[7] Hosp Sick Children, Transplant & Regenerat Med Ctr, Toronto, ON, Canada
[8] London Hlth Sci Ctr, Dept Phys Therapy, London, ON, Canada
[9] Univ Montreal, Dept Med, Div Endocrinol, Hosp Ctr, Montreal, PQ, Canada
[10] Univ Hlth Network, Toronto Lung Transplant Program, Toronto, ON, Canada
[11] Univ Montreal, Dept Med, Montreal, PQ, Canada
[12] Hosp Sick Children, Div Gastroenterol Hepatol & Nutr, Toronto, ON, Canada
[13] Vancouver Gen Hosp, Kidney & Pancreas Transplant Program, Vancouver, BC, Canada
[14] McGill Univ, Royal Victoria Hosp, Hlth Ctr, Montreal, PQ, Canada
[15] Univ Hlth Network, Kidney Transplant Program, Toronto, ON, Canada
关键词
QUALITY-OF-LIFE; 6-MINUTE WALK TEST; PEAK OXYGEN-UPTAKE; PEDIATRIC HEART-TRANSPLANT; RANDOMIZED CONTROLLED-TRIAL; IMPROVES AEROBIC CAPACITY; SKELETAL-MUSCLE STRENGTH; HIGH-INTENSITY EXERCISE; BONE-MINERAL DENSITY; ALL-CAUSE MORTALITY;
D O I
10.1097/TP.0000000000002806
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. The objectives of this position statement were to provide evidence-based and expert-informed recommendations for exercise training in adult and children solid organ transplant (SOT) candidates and recipients and on the outcomes relevant to exercise training and physical function that should be evaluated in SOT. Methods. We identified randomized controlled trials (RCTs) and systematic reviews of exercise interventions in adult and pediatric SOT candidates and recipients. When RCTs were not available, studies of any design were reviewed. The key recommendations were based on scientific evidence and expert-informed opinion. Results. We recommended that exercise training should be offered in the pre- and posttransplant phase for both adults and children. In adults, exercise training pretransplant was safe, but there was insufficient evidence to provide specific guidelines on the training characteristics. RCTs in adult SOT recipients demonstrated that exercise training improved exercise capacity, lower extremity muscle strength, and health-related quality of life. To obtain benefits, exercise training should be of moderate to vigorous-intensity level, 3-5 times a week for a minimum of 8 weeks. In pediatrics, there is an urgent need for high-quality multicenter clinical trials in the pre- and posttransplant phases. Due to limited evidence, specific recommendations regarding training characteristics could not be provided for pediatrics. Conclusions. The clinical relevance of this position statement is that it provides a key step toward raising awareness of the importance of exercise training in SOT patients among transplant professionals. It also identifies key areas for further research.
引用
收藏
页码:E220 / E238
页数:19
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