Page 157 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation evidence based or best practice guideline on exercise testing and training in recipients of
solid organ transplantation. In accordance with this, information for recipients should be
updated to include the current knowledge about physical activity levels, consequences of
inactivity, often experienced barriers to physical activity, and other associated factors of
physical activity. Insight into commonly experienced barriers and associated factors will
likely help recipients in recognizing their own.

e indicated barriers and other associated factors of physical activity and sedentary
time should be taken into account in physical activity assessment and rehabilitation
programs. Part of the indicated associated factors could be included in educational
modules, however, rehabilitation programs or physical activity interventions should
especially employ well guided training to provide recipients the experience of how exercise
should feel, what signals to keep in mind, and how to adjust training.
Health care professionals in transplantation
After transplantation, all recipients are monitored or treated by a physical therapist in the
hospital setting, however, as the geographical area of recipients is wide, recipients’ physical
therapy treatment is usually not followed up at the transplant center. After discharge,
referral to treatment by a physical therapist in the community is provided in most cases.
However, as the results of the studies in this thesis indicate, the results on improving
exercise capacity and the physical activity level appear to be limited. One factor that, from
clinical experience, seems to contribute to this limited improvement is the insu

cient
knowledge on the training of recipients of solid organ transplantation.
knowledge was substantiated by the fact that ‘expertise of personnel’ was an important
factor that emerged in the qualitative study on barriers to and facilitators of physical
activity among recipients of solid organ transplantation (Chapter 4). Inadequate knowledge
of the local physical therapist was indicated as a factor that could incite a negative feeling
c population of physical therapists and other exercise specialists is the relatively small

is lack of
about being physically active and even result in recipients discontinuing training.
speci

A factor that is likely to contribute to the insu

cient amount of knowledge on this
population of recipients of solid organ transplantation and the geographically wide
distribution of them. As a consequence, therapists do not become familiar with the
population as they rarely have recipients under treatment. Furthermore, assessment and
treatment of this speci

c population is not an element of the educational program in any
university of applied sciences, as far as we know. Improving knowledge, information
material, and education in physical therapists and other exercise specialists is key for
achieving the goal of improving the physical activity level in recipients of solid organ
transplantation. A situation in which expert centers on physical activity for this population
are established could provide a potential alternative or a worthwhile addition to increasing
information and training. Assessment, initial set-up of schedules, and follow-up could be
performed in the expert center and execution of the program could be performed by the
recipients’ local physical therapist with guidance from the expert center.
In general, physical therapists should not only be focused on and employed in the
treatment of acute problems in a person’s ability to move and perform functional activities
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