Background

Pre-habilitation may help lung transplant candidates improve or maintain their physical function during the waiting time for transplant. Telerehabilitation may enhance patient monitoring and adherence.

Objective

To estimate the extent to which a 12-week virtual pre-habilitation program affects exercise capacity, frailty, lower limb strength and health-related quality of life (HRQL) in lung transplant candidates.

Methods

Design: single-arm prospective longitudinal study. The 12-week virtual pre-habilitation program offered supervised strengthening exercises through a video conferencing platform and independent aerobic exercises. The primary outcome was six-minute walk distance (6MWD). Secondary outcome measures: Short Physical Performance Battery (SPPB), five-times sit-to-stand test (5STS), the St George?s Respiratory Questionnaire (SGRQ), adherence and adverse events.

Results

Twenty lung transplant candidates were included; fourteen completed the pre-habilitation program. There was no statistically significant improvement in 6MWD. However, most patients either maintained (N=8) or improved (N=3) their walking distance. There was a statistically significant improvement in the 5STS (10.0 ± 2.6 vs 8.6 ± 2.0 seconds, p=0.009). There was no statistically significant improvement in the SPPB, but patients either maintained (N=10) or improved (N=4) their score.  There was no statistically significant improvement in the SGRQ. Participants attended more than 90% of the virtual sessions. There were no adverse events.

Conclusion

Lung transplant candidates can improve their lower limb strength and maintain their exercise capacity and frailty status after participating in a 12-week virtual pre-habilitation program.