Project details

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The effectiveness of a lifestyle intervention program on physical capacity and movement behaviour in recipients of solid organ transplantation

Keywords:
Pulmonary rehabilitation organ transplantation psychosocial and lifestyle determinants

Researchers:
dr. H. van der Vaart
Janneke Dilling

Type of project:
Stage Wetenschap / Researchproject

Nature of the research:
The study design is an open label randomized controlled trial.

Fields of study:
pulmonology rehabilitation

Background / introduction
The majority of recipients of solid organ transplantation does not meet the recommended amount and type of physical activity. A more sedentary and inactive lifestyle is reported when compared to the general population. Transplant recipients have a maximal rate of oxygen consumption (VO2peak) below the normal range and this reduction in VO2peak is present despite the restoration of near normal organ function after transplantation. Besides a reduced exercise capacity, around 30–50% of recipients develop comorbid conditions such as osteoporosis, metabolic syndrome and diabetes in the years following transplantation.
We hypothesize that rehabilitation after transplantation will improve exercise capacity and physical activity and reduce metabolic syndrome in patients after transplantation
Research question / problem definition
To assess the additional value of a five day comprehensive assessment and intervention program on exercise and lifestyle followed by a six months maintenance program in primary care
Workplan
Study design: Patients that undergo a lung, liver, kidney or heart transplantation are asked to participate. Recruitment, inclusion and randomization will take place three to five months after discharge after transplantation. Patients will be randomized between the rehabilitation group and control group.

Six to eight months after discharge after transplantation the rehabilitation group will receive a five day comprehensive assessment and intervention program on exercise and lifestyle at the UMCG, CvR, location Beatrixoord. The week before the assessment, patients will wear a body monitoring system for one week and fulfill the questionnaires online. The assessment is followed by a six months maintenance program in primary care or at home, on top of usual medical care.

A control group is included to measure and correct for natural recovery after solid organ transplantation. The control group will receive instructions by the physiotherapist from the hospital how to exercise and improve their physical activity at home and when needed a referral to a primary care physical therapist.. The control group undergoes the same physical tests and questionnaires at six to eight months after discharge after transplantation as the rehabilitation group and will also wear a body monitoring system for one week.

Six months after T0 all physical tests and questionnaires will be repeated in both the control and rehabilitation group. A body monitoring system will be worn for one week to obtain information on physical activity.

The control group is offered the possibility to participate in the rehabilitation program after the study.

Workplan student: To participate in the organisation of the study, monitor patients, collect data, make a subanalysis of collected data for yoyr own research project.
References
- Reinsma GD, ten Hacken NHT, Grevink RG, Van der Bij W, Koeter GH, Van Weert E. Limiting factors of exercise performance 1 year after lung transplantation. The Journal of heart and lung transplantation 2006; 25(11):1310-1316.
- van Adrichem EJ, Dekker R, Krijnen WP, Verschuuren EAM, Dijkstra PU, van der Schans CP. Physical activity, sedentary time, and associated factors in recipients of solid organ transplantation. Phys Ther. 2018; 98(8):646-657.
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