Page 171 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation
longitudinal change in 6-minute walking distance, as a measure of functional exercise
capacity and to identify factors contributing to this change. Data of 108 recipients were
included and linear mixed model analysis revealed that time after transplantation,
diagnosis, gender, quadriceps muscle and grip strength, forced expiratory volume in 1
second (percentage of predicted), and length of hospital stay were factors that predicted 6-
minute walking distance.

e 6-minute walking distance increased considerably in the
rst
6 months after transplantation, however, this increase reduced thereafter. At 12 months
after lung transplantation, 58.3% of recipients did not reach the cuto

point of 82% of the
predicted 6-minute walking distance. Logistic regression demonstrated that discharge
values for forced expiratory volume in 1 second combined with quadriceps strength or grip
strength were predictive for reaching this cuto

point. From the results of this study it is
concluded that peripheral muscle strength is a predictor of 6-minute walking distance; this

in
nding suggests that quadriceps strength training should be included in physical training
to increase functional exercise capacity. Attention should be paid to further increasing 6-
minute walking distance between 6 and 12 months after transplantation.

e level of physical activity in recipients of solid organ transplantation can be

uenced by several experienced barriers and facilitators.

e number of studies on this
topic is, however, limited and no studies are available in which all types of solid organ
transplantation recipients were included. In a
qualitative study was performed. In the study, described in

rst attempt to explore the experienced
barriers to and facilitators of physical activity in recipients of solid organ transplantation, a
Chapter 4
, semi-structured in
depth interviews were conducted to explore the experienced barriers and facilitators.
e
most important experienced barriers were physical limitations, insu

cient energy level,
fear, and comorbidities.

e most frequently mentioned facilitators included motivation,
coping, consequences of (in)activity, routine/habit, goals/goal priority, and responsibility for
the transplanted organ. Neutral factors acting as a barrier or facilitator were self-e

cacy
and expertise of personnel. A comparison of barriers and facilitators between transplant
recipient groups yielded no overt di

erences. In intervention development to increase
physical activity behavior in recipients of solid organ transplantation these personal and
environmental factors should be considered.
To get more insight into experienced barriers to and facilitators of physical activity
in recipients of solid organ transplantation larger studies are warranted.

e Barriers and
Motivators Questionnaire is a questionnaire that can be used to assess barriers to and
motivators of physical activity experienced by recipients of solid organ transplantation. To
improve the application in research and clinical settings the underlying dimensions of the
questionnaire were explored.

e results on the analysis of the multidimensional structure
of a questionnaire to assess barriers to and motivators of physical activity in recipients of
solid organ transplantation is described in
indicated that it could be subdivided into four components (fear of negative e
Chapter 5.
Explorative principal component
analyses were performed on cross-sectional data on the Barriers and Motivators
Questionnaire of 591 recipients of solid organ transplantation. Analysis of the barrier scale

ects;
physical limitations; low expectations and self-con
with the
alpha
of the corresponding subscales varying between 0.66 and 0.80.

dence; and lack of motivation or time)
e
169.