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Effects of an acute, outpatient physiotherapy exercise program following pediatric heart or lung transplantation

Authors

  • R. D. Deliva,

    Corresponding author
    1. SickKids Transplant and Regenerative Medicine Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
    • Division of Physiotherapy, Hospital for Sick Children, University of Toronto, Toronto, Canada
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  • A. Hassall,

    1. Division of Physiotherapy, Hospital for Sick Children, University of Toronto, Toronto, Canada
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  • C. Manlhiot,

    1. Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
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  • M. Solomon,

    1. SickKids Transplant and Regenerative Medicine Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
    2. Division of Respiratory Medicine, Hospital for Sick Children, University of Toronto, Toronto, Canada
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  • B. W. McCrindle,

    1. Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
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  • A. I. Dipchand

    1. SickKids Transplant and Regenerative Medicine Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
    2. Labatt Family Heart Centre, Hospital for Sick Children, University of Toronto, Toronto, Canada
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Robin Deliva, Department of Rehabilitation Services, Hospital for Sick Children, 555 University Ave, Toronto, Ontario M5G 1X8, Canada

Tel.: 416 813 6755

Fax: 416 813 8557

E-mail: robin.deliva@sickkids.ca

Abstract

This prospective interventional study investigated the impact of a three-month, ambulatory HA or HB, semi-individualized, PT-prescribed exercise program following pediatric HTx or LTx. SMW distance, strength, and flexibility were assessed at start and completion of the program and one yr after enrollment. Subjects received either an HB or HA exercise program three times per week. The cohort demonstrated clinically and statistically significant improvements in SMW distances at three months (425.7 ± 109.4–500.6 ± 93.6 m, p < 0.001) and at one yr (528.5 ± 66.6 m, p = 0.001), although there was no difference between the two groups at any time. Similar improvements were also observed in strength and flexibility measures. Correlates with higher SMW distance at three months and one yr included older age, male gender, and underlying diagnosis other than CHD. Male gender and diagnosis other than CHD were associated with a slower improvement in the SMW distance. This is the first report of institutionally based, outpatient exercise rehabilitation in the recovery following pediatric thoracic transplantation. We found similar improvements to HB interventions up to one yr after surgery. Further study of the role of exercise rehabilitation and long-term fitness outcomes is needed.

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