Page 158 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 8
of daily life. Developments in the health care system require physical therapists to be
involved along the continuum of health care settings and coach patients and their
surrounding system in lifestyle management. In that way, it is most likely that long-term
goals to sustain and improve functional status are reached. In accordance with this, physical
therapists and exercise specialists as well as all other health care providers in the
solid organ transplantation. What is known is that there are large di
di
erent organ transplantation programs nationally and maybe even more internationally.

erences between the

eld of
organ transplantation should not only specialize in their individual profession but should
also be capable of identifying issues in adjacent areas as well. All healthcare professionals
should be able to provide basic information and referral to the appropriate discipline when
necessary. A professional should possess in-depth knowledge and expertise in a single
areas of expertise outside of their own.
is is also referred to as a T-shaped professional. A

eld
but should also have the ability to collaborate between disciplines and apply knowledge in

combination of T-shaped will result in the optimal specialized interdisciplinary team. A
collaboration in interdisciplinary teams directed at holistic, patient centered care is required
to optimize chronic diseases or chronic condition management. Furthermore, it would be
most valuable if one team could manage the same patients across the continuum of the
disease.
Rehabilitation programs and physical therapy interventions
Little knowledge is available concerning existing rehabilitation programs for recipients of

In some transplantation programs, it is common for an individual to be referred to a
rehabilitation setting directly after discharge from the hospital after transplantation; in
some programs, it is common to refer to a community practice and, in some programs, no
referral at all is provided. In this latter case, follow-up on physical activity is usually not
provided.
A recent systematic review and meta-analysis on exercise training regarding
recipients of solid organ transplantation showed that exercise training including aerobic,
resistance, or combined training improves physical functioning and quality of life for these
recipients.
156.
43
Exercise capacity is notably increased after exercise training in recipients of a
heart transplantation, however, results for the other transplantation groups is too limited
for concise conclusions to be drawn. Structured exercise training in transplant recipients
exercise was expressed as being motivational, o

ering peer support, and assistive in patients
ay are
44 44
has been indicated to have the potential to reduce cardiovascular risk factors such as hypertension and percent body fat and increase aerobic tness.1 e trials up to tod
small, of relative short duration, and focused on surrogate outcomes instead of hard
endpoints (i.e., heart rate, blood pressure, and body composition instead of cardiovascular
risk factors, and survival). Furthermore, follow-up time is limited and, therefore, the long-
term e

ects of physical activity interventions in the populations are unknown.
From the recipients’ perspectives, rehabilitation is indicated to be important. A recent study
on patients’ expectations and experiences of rehabilitation following lung transplantation
indicated that post-transplantation rehabilitation was perceived as highly valuable.
Group
achieving their desired level of physical performance after transplantation.