Page 150 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 8
Physiological associates of physical activity
factors.
Another variable that was associated with functional exercise 15–19
Recipients’ reported barriers to and facilitators of physical activity
In the study described in Chapter 2, it was shown that the level of the cardiac markers and
physical activity were associated in recipients of renal transplantation. Cardiac markers
were highest in the most inactive group and lowest in the most active one.

is does not
make cardiac function a direct physiological determinant of the level of physical activity,
however, it does indicate that cardiac function and level of physical activity are associated
Peripheral muscle strength was indicated as an associate of functional exercise
capacity in recipients of lung transplantation (Chapter 3). In the analysis of the
longitudinal change of six-minute walking distance, quadriceps strength was indicated as
the only directly amendable variable that predicted the distance and thereby functional
exercise capacity. Quadriceps strength in combination with the forced expiratory volume in
one second was also predictive of recipients reaching the lower threshold of 82% of the
predicted six-minute walking distance, an indication of experienced impairment in
functional exercise capacity.
14
capacity and reaching the indicated threshold was recipients’ grip strength. Grip strength
on its own, however, is not a variable that is easily intervened on, but it is a factor that is
associated with general well-being, mortality, health related quality of life, the metabolic
syndrome, and frailty.
Besides being in

uenced by physiological associates, the level of physical activity in
recipients of solid organ transplantation is in

uenced by the experienced barriers to and
facilitators of physical activity, though it should be noted that perceived barriers and
facilitators are not consistently associated with the actual level of physical activity.

e barriers to and facilitators of physical activity for all types of solid organ
20,21
transplant recipients were studied in Chapter 4. Semi structured, in-depth interviews in
diverse groups of solid organ transplant recipients revealed the barriers and facilitators that
were the most salient.

e most important indicated 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’. Several of these barrier
and facilitators were similar to those common in the general population, however, speci
barriers and motivators were indicated as well (‘responsibility for the transplanted organ’/
‘fear of damaging the new organ’/ ‘side-e
recipient groups yielded no overt di

e barrier and motivator components that were identi

erences.
ect of medication leading to physical
limitations’). Remarkably, a comparison of barriers and facilitators between transplant

ed in the study as described
in Chapter 5 were analyzed together with additional potential predictors in a large cohort
c
study on the level of physical activity and sedentary time in recipients of solid organ
transplantation (Chapter 6). Factors associated with the level of physical activity were
‘education level’, ‘exercise self-e
148.

cacy’, ‘employment status’, the barrier components ‘fear of