Page 14 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 1
sedentary and inactive lifestyle is reported when compared to the general population.
6,24–30
Whether there are di
is di

erences in activity levels between the several organ transplant groups
cult to assess because no studies have been performed in which all groups of solid
organ transplantation are assessed at the same time with the same instrument.
As indicated, the elimination of inactivity in the general population by increasing
physical activity levels and exercise and reducing sedentary time could result in substantial
health improvements and decreased mortality.
22
A su

cient amount of physical activity in
the general population is associated with a reduction in all-cause mortality, coronary heart
disease, high blood pressure, stroke, metabolic syndrome, type 2 diabetes, breast cancer,
colon cancer, depression, and falling.

ere is also strong evidence for physical activity
resulting in increased cardiorespiratory and muscular
22,31

tness, a healthier body mass and
composition, improved bone health, increased functional health, and improved cognitive
function.
concepts but are often used interchangeably or confused with each other
1985, distinct de
tness’.
40
40
41
42
22
In the transplant population, the level of physical activity is, furthermore,
positively associated to the capacity to perform activities of daily life
33–36 37–39

nitions were introduced to distinguish them. Physical activity is de
32
, the experienced
quality of life
, and survival.
De

nitions and guidelines on physical activity and exercise
In order to further discuss the role of physical activity and exercise in improving health, it is
important to clarify de

nitions of these terms. Physical activity and exercise are di

erent
while, already in

ned
as ‘any bodily movement produced by skeletal muscles that results in energy expenditure’.
Physical activity in daily life concerns all physical activities during the day and can be
categorized into occupational, sports, conditioning, household, and other activities.
Exercise, in its turn, is de

ned as ‘a subset of physical activity that is planned, structured
and repetitive and has a
40

nal or intermediate objective to improve or maintain physical

e amount of physical activity to promote or maintain health for adults is
indicated in national and international guidelines.

e recommendations from the
American College of Sports Medicine and the American Heart Association
, which are
also used in the Netherlands as the Dutch Norm for Health-enhancing Physical Activity
(Nederlandse Norm Gezond Bewegen), are presented in Box 1.
Factors associated with inactivity of transplant recipients
physical activity which are primarily unexplored in this population.
As previously stated, the reported levels of physical activity after transplantation are
limited. It is not fully clear why solid organ transplant recipients do not regain normal
levels of exercise and functional capacity as physical activity is determined by many
individual and environmental factors. Several physical factors speci

c to transplantation are
likely to be associated with the decreased physical activity levels. From a behavioral
perspective, recipients are expected to experience several barriers to and facilitators of
12.