Page 95 - Physical activity in recipients of solid organ transplantation - Edwin J. van Adrichem

Physical activity in recipients of solid organ transplantation questionnaire in cohort studies and prediction models for physical activity is thereby
increased, and clinical applicability is expanded. In the clinical practice of a rehabilitation
physician, the use of the questionnaire with its component structure could result in a faster
assessment of problem areas in daily practice and result in a higher degree of clarity.
results of the assessment can guide various topics addressed in the consultation and provide
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e
input for possible referral of the recipient for further assessment or treatment by allied
health care professionals. For instance, when the assessment of a recipient indicates that
‘fear of negative e
improving knowledge on the e

ects’ is a highly salient component, attention should be paid to

ects of physical activity and gaining experience on this.
Whether the rehabilitation physician will refer the recipient to a physical therapist with a
behavioral approach or a psychologist will depend on the severity of complaints and the
individual recipient. Components endorsed as motivators can be used for positive
endorsement to potentially stimulate or preserve physical activity behavior. On a group
level, as an example, the ‘health and physical outcomes’ of being active could be emphasized
to motivate recipients with insu

cient physical activity levels.
Previously, the use of the questionnaire in dialysis patients
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resulted in an indication of the most salient barriers to and
and in kidney
transplant recipients
motivators for physical activity in these populations. In both studies, the questionnaire was
evaluated per item and not as components of items measuring the same construct.
However, in the study in kidney transplant recipients, a self-clustered group of health-
related barriers was reported containing items such as ‘shortness of breath’ and ‘being too
fatigued’ that are largely clustered under the component ‘physical limitations’ in the current
study. In the same study, a group of highly salient motivators are described together in a
cluster of ‘health-related facilitators’ containing the items ‘feeling healthy’, ‘wanting to feel
better’, ‘wanting increased health’, ‘wanting increased strength’, and ‘wanting enhanced
physical mobility’.

ese same items are clustered together in the motivator component
‘health and physical outcomes’ in the current study.

e lack of use of components in the
study limits the overview of transcending constructs of barriers and motivators that
potentially in

uence physical activity levels.

e study in kidney transplant recipients
ascertained no signi

should be considered in future research.
cant di

Although one could hypothesize that di
experienced in di
erences between physical activity groups, however, a
consistent trend was found with the more physically active group endorsing fewer barriers
and more motivators compared to the less active group. Addressing the items together in
components may potentially reveal stronger associations with physical activity levels and

erent barriers and motivators can be

erent groups of solid organ transplant recipients, we analyzed the study
population as a whole to explore the underlying dimensions of the questionnaire. Where
the in

uence or contribution of a particular component on physical activity and sedentary
time may vary between di
e
questionnaire itself to di

er.
rent groups we do not assume the component structure of the

highly correlate to each other, presumably because they are in
underlying construct, this is not expected to be in

e additional analyses, looking into the di
e components structure re
ects the clustering of items that

uenced by the same

uenced by the type of organ received.

erences between barrier and motivator scores
93.
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