Page 16 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Chapter 1
(glycolytic, fatiguable) resulting in reduced muscle oxidative functioning and elevated blood
lactate during exercise.
50,51

e peripheral muscle dysfunction pre- and post-
transplantation appear to be the primary factor accountable for the impaired aerobic
capacity that is demonstrated pre-operatively and post transplantation when compared to
age-matched normative values.4
the transplant population. Barriers refer to perceived obstacles that hinder the performance
of physical activity, and facilitators refer to factors increasing the likelihood of performing
physical activity.
Diverse barriers to and facilitators of physical activity have been
indicated in end-stage kidney, liver, lung, and heart disease, however, only limited studies
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Interventions or intervention development
in intervention development.
Increasing participation in activities of daily life might be bene

cial for improving exercise
capacity and reducing the risk of developing noncommunicable diseases and negative side e ects of immunosuppressive medication.44 A meta-analysis on the e ects of exercise
training in solid organ transplant recipients indicated that exercise training is promising
but still not proven to be e

ective in reducing cardiovascular risk factors.
53

e available
studies are limited in number, the number of participants included, and follow up.
Furthermore, the reported outcome measures are inconsistent and are often surrogate
outcomes; studies report on exercise capacity and cardiopulmonary parameters but do not
transplantation groups. Clinical experience and the performance of transplant recipients at,
for instance, the World Transplant Games demonstrates that the range of physical
performance after transplantation is very wide.
exercise can potentially contribute to improving long-term outcomes and healthy aging
14.
Besides the (patho)physiological barriers to physical activity, several other barriers
to and facilitators of physical activity are likely to play a role in the physical activity level of
have been performed on this issue in transplant recipients. Insight into these issues within
the transplant population could provide insight into key elements needing to be addressed
54
55

43
e question is raised on why one
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report on cardiovascular related events, graft survival, and cardiovascular and all-cause
mortality.53
identi
ed.
recipients with the di

e most optimal type of rehabilitation and its key components are also not yet

us far, it is also not clear if a di
erent organ types that are received.

erent approach to rehabilitation is required for

e recommendations after
transplantation currently di

er per organ group. Where rehabilitation after heart
transplantation is considered as standard care
, this is not the case for the other solid organ
recipient can be or is physically active while another is not. Understanding why recipients
are physically active or inactive and the identi

cation of associated factors of physical
activity can contribute to the development of interventions.
As stated in a recent expert meeting report on exercise for recipients of a solid
organ transplantation, exercise and physical activity after transplantation are an element of
a long-term commitment that may lead to sustained improvements in physical functioning,
quality of life, and potentially improved survival.
In this aspect, physical activity and
after transplantation.