Page 132 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 7
All participants signed informed consent.

e study complied with the declarations of
Helsinki and Istanbul, and the Institutional Review Board of the University Medical
Center Groningen provided approval to conduct the study (M14.162650).
Cardio pulmonary exercise testing (CPET)
CPET was performed on a stationary electromagnetically braked cycle ergometer (Lode,
Groningen, the Netherlands) according to the international guidelines.9
participant (15–30 Watt). Breath by breath analysis using

e rate of
progressive increase in workload was adjusted to the (estimated)

tness level of the

ow and inspiratory and
expiratory gas fractions at the mouth was used to calculate all ventilatory variables
(CareFusion, Master Screen CPX, Germany).

e ventilatory and anaerobic thresholds
were determined by V-slope (VE/VCO2) and increments in O2 equivalent. Heart rate was
registered with a 12-point electrocardiography (KISS 10, GE Medical Systems), blood
pressure was monitored every two to three minutes by manual measurement
(sphygmomanometer and stethoscope), and the achieved maximal load was recorded. A
systolic blood pressure of 250 mmHg and a diastolic blood pressure of 130 mmHg were
indications for termination of the exercise test.
Peripheral muscle strength
11

e estimated metabolic equivalent (MET, one MET = 3.5 ml/kg/min) needed for
hiking (steep grade with 5-18kg pack) is 7.3 MET’s.
calculate the equivalent VO2max value by multiplying it by 3.5.
10

is MET value was used to
11

is resulted in a
estimated required VO2 value of 25.6 ml/kg/min. Based on this value the minimal (age
and gender adjusted) criterion for maximal oxygen consumption (VO2max) was
established at the level ‘fair/good’ according to the American College of Sports Medicine.
Maximal voluntary isometric strength of the quadriceps muscles was measured utilizing a
hand-held dynamometer (MicroFET IITM, Hoggan Health Industries, UT, USA).
Isometric handgrip strength was determined with a Jamar hand dynamometer (Lafayette
Instrument Company, USA). Measurements were performed three times for each muscle
group in testing positions described earlier.
12,13

e mean measured peak force in Newton
of the dominant side of the participant was used for further analysis and compared to
calculated predicted values.
14,15
Selection
A total of twelve OTR were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1
allogeneic stem cell- and 1 small bowel-transplantation). None of the selected OTR had
prior high-altitude mountaineering experience.

e convenience control group consisted of
14 participants of whom eight were members of the medical team. All members of the
medical team performed an exercise test to assure adequate exercise capacity to get along
with the group and provide support where necessary.
130.