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Cited by 30Cardiovascular and exercise physiologyTransplantation: Methods and OutcomesPhysical Activity and Health

Safety, adherence and efficacy of exercise training in solid-organ transplant candidates: A systematic review

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Wallen, Matthew P., Skinner, Tina L., Pavey, Toby G., Hall, Adrian, Macdonald, Graeme A., Coombes, Jeff S.·2016·Transplantation Reviews
DOI 10.1016/j.trre.2016.07.004
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Abstract

Background Patients awaiting solid-organ transplantation may be encouraged to undertake exercise training to improve pre- and post-transplant outcomes. However, the safety, adherence and efficacy of exercise training in this population remain unclear.Methods All randomized, non-randomized and non-controlled trials of exercise training interventions in solid-organ transplant candidates were included. The Cochrane risk of bias tool and a modified Newcastle-Ottawa scale were used to assess procedural quality. Safety was defined as the number of reported adverse events during exercise training. Adherence was evaluated from session attendance, and efficacy as changes in cardiorespiratory fitness (CRF), exercise capacity, muscular strength, health-related quality of life (HR-QoL) and lung function.Results Eleven studies involving 874 patients were included: four randomized controlled, one non-randomized controlled and six non-controlled trials. Six studies included heart transplant candidates and five involved patients awaiting lung transplantation. Three trials included aerobic-only training, one incorporated resistance-only exercise and seven combined modalities. Twelve adverse events were reported with four due to exercise, although methods to collect these data were often omitted. Exercise adherence ranged from 82.5% to 100%, but was poorly described. No significant between-group changes attributable to exercise training were demonstrated. However, significant within-group improvements in CRF, exercise capacity, muscular strength, lung function and HR-QoL were observed.Conclusions Patients awaiting heart or lung transplant appear to tolerate exercise training despite the larger number of adverse events compared to other high-risk populations. Exercise training demonstrated within-group benefits for several outcomes, with no significant between-group differences. Randomized controlled trials with sufficient statistical power are required for all solid-organ transplant candidates.

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  • Patients engaging in clinical trials may not be representative of the population in question, since their psychological predisposition to exercise may be different than the predisposition of the others.

    “However, this cannot be assumed for everyone in the general population and it could happen that patients engaging in clinical trials may not be representative of the population in question, since their psychological predisposition to exercise may be different than the predisposition of the others [15].”

    From Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review (2021) · cites this paper as [15]

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Authors
Wallen, M. P., Skinner, T. L., Pavey, T. G., Hall, A., Macdonald, G. A., & Coombes, J. S.
Affiliations
  • The University of Queensland (AU)
  • Queensland University of Technology (AU)
  • Princess Alexandra Hospital (AU)
Corresponding author
Macdonald, Graeme A.
ORCID
Venue
Transplantation Reviews
Publisher
Elsevier BV
Published
2016-10
Volume
30
Issue
4
Pages
218-226
ISSN
0955-470X (ISSN-L)
DOI
10.1016/j.trre.2016.07.004
OpenAlex
W2497475516
Cited by
30
References
78
Citations by year
2026: 3 · 2025: 1 · 2024: 7 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 2
FWCI
0.74
Type
journal article
Language
en
Open access
Licence
Locations
  • Transplantation Reviews (publishedVersion)
  • PubMed (publishedVersion)
  • QUT ePrints (Queensland University of Technology) (submittedVersion, cc-by-nc-nd)
  • FedUni ResearchOnline (Federation University Australia) (submittedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Surgery › Transplantation: Methods and Outcomes
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
exercise training, heart transplant candidates, lung transplant candidates, exercise safety, exercise adherence, cardiorespiratory fitness, exercise capacity, muscle strength, health-related quality of life, lung function, adverse events
MeSH terms
Exercise Therapy, Humans, Quality of Life, Exercise, Randomized Controlled Trials as Topic, Organ Transplantation, Muscle Strength

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