Page 172 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Summary
motivator scale could also be subdivided into four subscales (health and physical outcomes;
external in
uences; groups activities and

nancial resources; and psychological outcomes)
with
alpha o
f the subscales varying between 0.70 and 0.88. Nine of the original barrier
items and two of the motivator items were not included in the component structure.
e
four-dimensional structure of both the barrier and the motivator scale increases the
usability and interpretation of the questionnaire outcomes in research and clinical settings
compared to the overall scores and provide opportunities to identify modi

able constructs
to be targeted in interventions.
To increase knowledge on the amount of physical activity and sedentary time and
its associates in recipients of solid organ transplantation a cross sectional study in 656
recipients of a solid organ transplantation was performed. In the study in
Chapter 6
it was
indicated that less than 60% of the recipients complied to the physical activity guidelines.
Factors that were signi
‘health and physical outcomes’.

cantly associated with lower levels of physical activity included
being female; age (non-linear); not actively working or being retired; having physical
limitations; and low expectations and self-con

dence. Factors being signi

cantly associated
with lower sedentary time included exercise self-e

cacy, and not actively working or being
retired. More hours of sedentary time were seen in recipients with a high education, higher
fear of negative e

ects, having physical limitations, and scoring higher on the motivator

cantly in

uence
level of physical activity and reducing sedentary time in recipients of solid organ
transplantation, attention should be paid to physical limitations, fear of negative e e
expectations and self-con
dence, health and physical outcomes, and exercise self-e
ects, low

cacy.
Although general physical activity levels in recipients of solid organ transplantation
are reported to be low some recipients are very active and participate in competitive sports.
It is, however, generally unknown to what extent organ transplant recipients can be
physically challenged.
Chapter 7
describes an expedition to Mount Kilimanjaro during
which the tolerance for strenuous physical activity and high-altitude of organ transplant
recipients after various types of transplantation was studied. Twelve organ transplant
recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic
stem cell- and 1 small bowel-transplantation). Members of the medical team and
accompanying family members (n = 14) acted as controls. During the climb,
cardiopulmonary outcome variables and symptoms of acute mountain sickness were
recorded twice daily. Capillary blood analyses were performed three times during the climb
and once following return. Results showed that eleven of the transplant participants and all
controls began the

nal ascent from 4700 meters and reached over 5000 meters. Eight
transplant participants (73%) and thirteen controls (93%) reached the summit (5895m).
Cardiopulmonary outcome variables and altitude sickness scores demonstrated no
di

erences between transplant participants and controls. Signs of hyperventilation were
e
170.
e type of transplantation did not signi
either of the outcome measures. In intervention development directed at increasing the
more pronounced in transplant participants and adaptation to high-altitude was less
ective, which was likely related to a decreased renal function and indicates a reduced
metabolic compensation. Overall, tolerance to strenuous physical activity and feasibility of