Page 156 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 8
Taken together, with the guidelines and reference values not being speci

c for the
transplant population, it is di
speci

adequately.
Associated factors of physical activity
cult to assess if this population is active enough. Population
c physical activity guidelines and reference values which are concrete and tailored to
this population are needed in order to guide recipients of solid organ transplantation

e selection of associated factors studied in this thesis was aimed at indicating factors that
are amendable in rehabilitation settings or indicating subgroups within the population that
should be targeted due to the highest need of intervention.
levels in recipients of solid organ transplantation.
however, do not provide an inclusive overview of potentially associated factors of physical

e indicated barriers and
motivators should be considered in intervention development to increase physical activity

e factors studied in this thesis,
activity. Due to the multidimensionality of physical activity behavior, several behavioral
theories and models can be utilized to describe the diversity of associated factors of
physical activity behavior. Over the past decade, the use of ecological models to capture all
aspects in

uencing physical activity behavior and to incorporate concepts from several
theories (i.e., trans-theoretical model and theory of planned behavior) is becoming rather
common.40 With this approach, a comprehensive framework incorporating determinants on a personal, social, environmental, and policy level can be studied. Further extension of
the bio-psychosocial model in the future seems worthwhile in order to include all potential
in

uencers of physical activity behavior to identify amendable aspects.
Future directions in healthcare and research
most important implications are discussed in the following sections.
Directions in health care
Clinical practice
e

ndings of this thesis have several implications for clinical practice.
combination with developments in the
As it was indicated that the level of physical activity in recipients of solid organ
eld also provide direction for future research.
e

ndings in

e
transplantation is limited, there is a need to develop intervention strategies that improve
this. However, inextricably linked to this is the improvement of assessment and monitoring
of the level of physical activity and physical

tness within this population. Including
exercise testing as standard care would be valuable for monitoring development, indicating
the limiting factors, and generating training schedules. As was indicated previously in
literature, a prescription of physical activity is indicated as an undervalued intervention
and physical activity should be prescribed and encouraged as a component of routine post
transplantation care.
154.
42

As there are currently no adequate and speci

c guidelines for physical activity and
41,
exercise in recipients of solid organ transplantation, it is recommended to develop an