Depressive symptoms are associated with mortality and CLAD after lung transplantation, independent of exercise capacity.

The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation. Methods: Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression. Results: Participants (N 5 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1-3) after hospital discharge. The mean 6MWD of 324 m (SD 5 107) improved after rehabilitation to 488 m (SD 5 105). Factors associated with improvement were younger age (P 5 .003), higher baseline forced expiratory volume in 1 second (FEV 1 ) (P , .001), and lower baseline 6MWD (P , .001). Participants averaged 22 sessions in 41 days (IQR 35-50); with lower baseline FEV 1 (P 5 .002) and 6MWD (P , .001) associated with longer completion time. Conclusions: A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management.

Purpose-Rehabilitation can improve health outcomes in candidates for lung transplantation. The purpose of this study was to retrospectively evaluate the effect of a one-month physical therapy (PT)-based outpatient program on exercise capacity, symptoms, quality of life and examine predictors of functional outcome changes in adults awaiting lung transplantation. Methods-Participants (n=141) completed a 23-session exercise and educational program over one month. Outcomes included 6-minute walk distance (6MWD), San Diego Shortness of Breath Questionnaire (SOBQ), Center for Epidemiological Studies-Depression Scale (CESD), and Ferrans and Powers Quality of Life Index Pulmonary Version III (QOL). Results-Participants were older (median age 63) with restrictive (59%) or obstructive (24%) disease. Moderate-to-large improvements in 6MWD were observed (69 m, p < 0.001, d = 0.72), independent of demographics, symptoms, and QOL. Lower initial 6MWD and lower oxygen utilization were associated with greater 6MWD improvements, with largest gains occurring in initial 6MWD < 305 m. Small-to-moderate improvements were observed on CESD (p < 0.001, d = 0.26) and in overall QOL (p < 0.001, d = 0.27), with a non-significant improvement observed on SOBQ (p = 0.248, d = 0.13).