Page 148 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 8
Transplantation is a life-saving intervention for individuals with end-stage solid organ
disease and often the optimal treatment of the disease.1

e number of people that receive
an organ transplantation has been rather stable over the past decade, however, as short term
survival has been signi

cantly improved and long-term survival is increasing, the total
population of recipients of a solid organ transplantation continues to grow. With increasing
long term survival, new areas of medical and psychosocial attention arise in the population.
New onset diabetes after transplantation, medication adherence, quality of life, and the
level of physical activity have gained increasing attention especially because they are likely
modi

able and amenable for intervention to prolong long-term survival after
transplantation.
In this thesis, physical activity and factors associated with the level of physical
activity in recipients of solid organ transplantation were the main focus. As current
evidence suggests that greater physical functioning in transplant recipients is associated
with improved outcomes1
perform activities of daily life2
, physical activity in the transplant population is highly relevant.

e level of physical activity is indicated to be positively associated with the capacity to
, experience quality of life
organ transplantation and the factors associated with this level.
and to compose the appropriate content and focus areas in program development.
3–7
, and survival.
8–12
However, only
little is known about the level of physical activity in various groups of recipients of solid

is knowledge is required
in order to justify the need for rehabilitation programs or physical therapy interventions

erefore, the main objectives of this thesis were to gain additional insight into the
physical activity level of recipients of solid organ transplantation and into factors that are
associated with this level.
Level of physical activity

is chapter summarizes the primary
ndings of the studies in this thesis, and their
methodological considerations are discussed. Finally, the implications and future directions
in healthcare and research are provided.
Main

ndings
One of the main aims of this thesis was to investigate the level of physical activity of
recipients of solid organ transplantation.
recipients of a lung transplantation did not reach the cut-o
146.

e study in Chapter 3 showed that 58% of

point of the six-minute walk
test at 12 months after transplantation, indicating impairment of functional exercise
capacity.

is study remarkably showed an initial steep increase in submaximal exercise
performance between discharge and six months after discharge, however, this increase was
reduced in the second half of the

rst year following transplantation. In line with these
ndings the study described in Chapter 6, showed that, in a study population of diverse
types of transplantation, less than 60% of recipients complied with the general physical
activity guidelines. Comparing the level of compliance to the physical activity guideline in
the transplant population with that of the average Dutch population indicated that the
percentage in those with a transplantation were exceedingly below reported levels in the