Page 53 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Table 4.
Logistic Regression Analyses (Models 1 and 2) of 6-Minute Walking
Distance Performance of Recipients of Lung Transplantationa
Model Parameter at T1 1b Constant
Quadriceps force, N
2c Constant
Grip strength, N
β (SE) P
Physical activity in recipients of solid organ transplantation
Lower bound of 95% CI
Upper bound of 95% CI
FEV1
, % of
0.70 (0.40) 0.04 (0.02) 0.02 (0.01) 0.59 (0.35) 0.04 (0.02) 0.06 (0.02)
2.02 .076 1.01 1.04 1.08 .038 1.01 1.02 1.03 .004 1.80 .097 1.00 1.04 1.08 .050 1.02 1.06 1.09 .001
Odds ratio
predicted value
FEV1
, % of
predicted value
a Reaching 82% of the predicted value at T3 (12 months after lung transplantation). T1, discharge. b Signi cance of Hosmer-Lemeshow goodness-of- t test: P=.89. Pseudo R2 =.24 (Cox & Snell) or .32 (Nagelkerke). Model 2= 18.85, df=2, p<.001. 0= not reaching 82%, 1= reaching 82%. FEV1 was centered at 65% of predicted; quadriceps force was centered at 250 Newton. c Signi cance of Hosmer-
2
Lemeshow goodness-of- t test: P=.62. Pseudo R = .32 (Cox & Snell) or .42 (Nagelkerke). Model "2 =
25.62, df=2, P<.001. 0= not reaching 82%, 1= reaching 82%. Forced expiratory volume in 1 second
(FEV1
) was centered at 65% of the predicted value; grip strength was centered at 91 N.
Discussion
e

ndings of this longitudinal study suggest that, besides LTx itself increasing lung
function, quadriceps strength was the only directly modi
FEV, were factors signi
reaching the lower bound of 82% of the predicted value was grip strength.
improvement in 6MWD between discharge and 6 months was not continued up to 12
months after LTx. At 12 months after LTx, more than half of the recipients had an
inadequate walking distance (<82% of the predicted value).

e results for 6MWD at 12 months after LTx may be explained by the sedentary
lifestyle that was previously shown for recipients of LTxs.
8,25
With 6MWD being an
indicator of sedentary behavior
as well as a good representative of the ability to perform
physical activity in daily life,
strength, seems to be important. A su
of daily life
25
and to increase the quality of life
30
25 26
28–30

cantly predicting recipients reaching the lower bound of 82% of
able variable that predicted
6MWD and thereby functional exercise capacity. Additionally, quadriceps strength and

the predicted 6MWD. Another factor contributing signi

cantly to 6MWD and to
cient exercise capacity is highly relevant in
Performance on the 6MWD test during the waiting list period has been shown to be a
27

e initial
increasing 6MWD, potentially by increasing quadriceps

recipients of LTxs; it not only is expected to increase the possibility of performing activities
but also is related to survival.
28–30
predictor for surviving this waiting list period
and for survival after LTx across all lung
disease categories,
with shorter 6MWD values being associated with increased mortality
rates. Lower exercise capacity at 1 year after LTx was also indicated to be independently
associated with increased mortality.
31
51.
3