Correlates and Outcomes of Low Physical Activity Posttransplant: A Systematic Review and Meta-Analysis

Abstract

Background. Little is known about associations between low physical activity (PA) and its correlates and outcomes in solid organ transplant recipients. This systematic review with meta-analysis examined correlates and outcomes associated with low PA (ie, not meeting individual study’s definition of being physically active) following solid organ transplantation. Methods. We searched PubMed, CINAHL, PsycINFO, and EMBASE from inception to February 2016 to identify peer-reviewed data-based articles. Articles published in English, German, Spanish, French, Italian, Portuguese, or Dutch that examined correlates or outcomes associated with low PA in adult single, solid organ transplant recipients were included. Studies’ quality was assessed using a 14-item checklist. Pooled odds ratios and 95% confidence intervals were computed for correlates and outcomes examined in ≥5 studies. Results. Of 7401 publications screened, 34 studies met inclusion criteria and were included in the overall synthesis with 15 included in the meta-analysis. Most focused on renal transplantation (n = 18, 53%) and used cross-sectional designs (n = 26, 77%). Of 30 correlates examined, [condition-related (n = 11), social/economic-related (n = 9), patient-related (n = 4), healthcare system-related (n = 3), and treatment-related (n = 3)], only 4 were examined ≥5 times and included in meta-analyses. None were significantly related to low PA. Of 19 outcomes assessed, only physical health-related quality of life was examined ≥5 times. Low PA was significantly associated with low physical health-related quality of life (odds ratio = 0.172, 95% confidence interval = 0.08–0.37). Conclusions. We found few studies examining most correlates and outcomes related to low PA despite growing evidence that improving PA might be an effective intervention in improving posttransplant outcomes.

Prevalence and Correlates of Accelerometer-Based Physical Activity and Sedentary Time Among Kidney Transplant Recipients

“…Few studies have examined correlates of physical activity and sedentary behaviors in the solid organ transplant context. 10 Our study is one of the first to examine correlates of accelerometer-based physical activity, light intensity activity, steps, and sedentary time in kidney transplant recipients. While MVPA was inversely associated with age, steps/day was inversely associated with age and positively associated with income.…”

“…9 Accelerometers now provide a means for more precise and, accurate estimates of sedentary time and physical activity. A recent systematic review and meta analysis by Berben and colleagues 10 examining correlates and outcomes of low physical activity post transplant reported few studies in the area of solid organ transplant recipients. These studies relied primarily on self-reported estimates of physical activity, and the authors recommended researchers should use activity monitors to document physical activity.…”

Prospective single-centre clinical observational study on electronically monitored medication non-adherence, its psychosocial risk factors and lifestyle behaviours after heart transplantation: a study protocol

“…35 No significant risk factors were found for low physical exercise. 36 Most of these studies are based on the results of kidney recipients, while research on heart recipients is rare. Especially studies connecting non-pharmacological NA with electronically monitored IS NA in HTRs are missing.…”

Relationships of accelerometer‐determined physical activity with obesity, hypertension, diabetes, dyslipidemia, and health‐related quality of life in patients after liver transplantation

“…15 A systematic review of low PA-related outcomes in solid organ transplantation patients showed that the predictors of low PA are older age, male sex, high BMI, a longer time since transplantation, and lower physical health-related quality of life (HRQOL). 16 HRQOL is an important outcome for patients who undergo transplantation, and a previous study showed associations between HRQOL, assessed using the short form (SF)-36 survey, and activity level 17 in post-LT patients. Physical Component Summary (PCS), but not Mental Component Summary (MCS), was associated with the level of PA, assessed using the self-reported frequency and duration of dedicated exercise, and specifically, "physical functioning," "role physical," bodily pain, general health, and PCS were associated with the PA level.…”

“…A systematic review of low PA‐related outcomes in solid organ transplantation patients showed that the predictors of low PA are older age, male sex, high BMI, a longer time since transplantation, and lower physical health‐related quality of life (HRQOL) 16 …”