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Abstract

Objectives: The frequency and success rates of lung transplant in patients with end-stage lung disease are increasing. In our study, we investigated the effects of preoperative pulmonary rehabilitation on pulmonary function, exercise capacity, and quality of life in patients who are candidates for lung transplant. Materials and Methods: This prospective study included 39 consecutive patients who were candidates for lung transplant. All patients underwent preoperative pulmonary rehabilitation for at least 3 weeks. Results: Our patient group included 25 male and 14 female patients with a mean age of 36 years (range, 15 -68 y). Although no significant improvement was shown in the forced expiratory volume in 1 second after pulmonary rehabilitation, significant improvements were observed in the Modified Medical Research Council dyspnea scores (P = .001) and 6-minute walk distance (P = .001). We also observed statistically significant improvements in the ShortForm 36 Quality of Life Questionnaire's physical function (P = .01) and emotional role (P = .02) subparameters. We also found a significant improvement in the Beck Depression Inventory score (P = .004). There was no correlation between Beck Depression Inventory scores before and after rehabilitation and 6-minute walk distance, Short-Form 36, and Modified Medical Research Council dyspnea scores. Conclusions: Our results suggest that preoperative pulmonary rehabilitation improves exercise capacity, reduces the sensation of dyspnea and muscle strength loss, and has a positive effect on the psychologic state of patients who are candidates for lung transplant. Key words: Dyspnea, Muscle loss, Psychologic assessment IntroductionLung transplant is the last treatment option for endstage lung disease patients for whom conservative treatments have failed. 1 A pulmonary rehabilitation (PR) program has an important role in this group of patients who have chronic lung diseases and complex medical histories. 2 Studies have shown positive effects of PR programs in patients who are on wait lists for transplant and have shown that postoperative outcomes are improved in patients who can obtain higher preoperative exercise capacity. 3 In chronic pulmonary diseases such as chronic obstructive pulmonary disease, bronchiectasis, and interstitial lung disease, the efficacy and reliability of exercise have been well-documented. [4][5][6] However, data are still scarce on the safety and efficacy of exercise in patients with end-stage lung disease who are transplant candidates. Evidence-based exercise training programs for pre-and postoperative stages of transplant have not yet been developed. Considering the exercise principles and recom mendations in the guidelines for the care of adults with chronic pulmonary disease, exercise training programs should be established to offer optimal health benefits for transplant candidates on wait lists. 7 Patients prepared for lung transplant are a select patient population with advanced chronic lung disease. These patients typically have ven...

<p>Impact of preoperative exercise therapy on surgical outcomes in lung cancer patients with or without COPD: a systematic review and meta-analysis</p>

“…However, pulmonary function testing in this meta-analysis showed that most of the investigated parameters of pulmonary function were comparable or even slightly lower after exercise, though not significantly. A similar result was reported in other surgical procedures, such as lung transplantation 27. Irreversible lung function after exercise training might represent the severity of the baseline condition of the lung disease and may not be the priority of treatment planning.…”

Pulmonary Rehabilitation Accelerates the Recovery of Pulmonary Function in Patients With COVID-19

“…It has also been confirmed to be an important part of the integrated care strategy for chronic obstructive pulmonary disease (COPD) ( 5 , 6 ). Its positive effects in preoperative pulmonary rehabilitation were also discovered including reducing the sensation of dyspnea, reducing muscle strength loss associated with dyspnea, and improving psychologic states ( 7 ). As for infectious disease of respiratory system, Hsieh et al ( 8 ) found that survivors of acute respiratory distress syndrome (ARDS) caused by influenza A (H1N1) who received pulmonary rehabilitation for 2 months had improved pulmonary function, exercise capacity, and quality of life.…”

Does Preoperative Rehabilitation Influence the Quality of Life in Patients Who Are Candidates for Lung Transplant?

“…One study was a systematic review, 17 and the other was an observational prospective study. 11 There were 1344 patients, of whom 48% were men, that constituted the cohort of the included studies. The systematic review included 6 studies that evaluated the correlation between preoperative rehabilitation and quality of life in LTx candidates.…”

“…Although respiratory function can improve after LTx, the negative effects of the chronic underlying disease may continue, mostly in the musculoskeletal and cardiopulmonary systems. 9 Preoperative rehabilitation can contribute to enhancing exercise capacity, reducing dyspnea, and improving muscle strength and thereby positively influence patients' quality of life 10,11 and facilitate favorable physical and psychological conditioning for patients before surgery. 12 Enhancing muscle strength aerobic capacity preoperatively also allows patients to become accustomed to exercise, especially considering that the waiting time on the active list can vary.…”