Page 55 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation general daily physical activity levels, possibly by recipients altering their lifestyles, appears
to be worthwhile.
Potential limiting factors of the present study were the lack of knowledge about the
course of disease during the waiting list period and the lack of knowledge about the
duration, frequency, and type of training after LTx. Likewise, comorbidities were not
systematically recorded and remained an unknown confounder. Regarding grip strength,
only values measured with the MicroFET II were available; preferably, the Jamar
dynamometer (Sammons Preston Rolyan, Bolingbrook, Illinois) would have been used to
facilitate comparisons with other studies and reference values. Furthermore, because all
measurements took place over a period of 10 years, outcomes were measured by di

erent
personnel; this situation may have caused bias. However, we used standardized and reliable
measurement methods
points may have in
14,20,26,40
to minimize this risk. Moreover, the number of missing data

uenced the outcome. However, the additional analysis after data
imputation con

rmed the robustness of most of the predictive variables.

e contribution
of DLCO to the logistic regression analysis on reaching 82% of the predicted 6-MWD
could not be determined because of insu

cient data points and must be clari

ed in future
research. Finally, the models presented were based on data from recipients who survived at
least half a year (data from 3 measurement moments were available); this situation may
have in

uenced the outcome. However, because the main outcome measurement was
related to the course of recovery up to 1 year after LTx, the models addressed this
population. Overall, these limitations suggest the need for some caution in the
interpretation of the data and con
should be paid to the period between 6 and 12 months.

rmation by additional research.
In conclusion, the

ndings of the present study are in line with previous

ndings and
provide additional evidence that physical therapist interventions should include quadriceps
muscle force training to increase functional exercise capacity; however, the program should
be more extensive.

e course of recovery after transplantation indicates that attention

e Institutional Review Board of the University Medical Center Groningen provided
approval for the use of clinical data (M13.146042).
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