Effectiveness of Pulmonary Rehabilitation on Exercise Capacity in Adult Patients with Lung Transplantation: Single-Arm Meta-analysis (Preprint)

Abstract

BACKGROUND Lung transplantation (LTx) is a well-established option for patients in the end-stage lung disease that is not responsive to other treatments. Although the survival rate after LTx has seen a significant increase, exercise intolerance still limited and poses a big obstacle to recovery after LTx. Pulmonary rehabilitation (PR) is a comprehensive intervention that has many benefits for patients with chronic respiratory disease. However, the effectiveness of PR on adult patients with LTx is inconclusive. We performed this meta-analysis to assess the efficacy of PR in adult LTx recipients. OBJECTIVE The purpose of this meta-analysis was to explore the effectiveness of PR on exercise capacity in adult patients with LTx. METHODS Eligible randomized controlled trials (RCTs) and quasi-experimental studies published until March 25, 2024 2024, were searched in MEDLINE, Embase, Web of science and CINAHL. Additionally, reference lists and published systematic reviews were scanned by manual searching. Studies selection, data extraction, and risk of bias assessment were conducted independently. Stata software (version 17.0) was utilized. RESULTS 21 studies (9 RCTs and 12 quasi-experimental studies) were identified. Pooled analysis showed that PR positive effect in improving six minutes walking distance(6MWD) (SMD 1.28, 95% CI 1.05–1.50, P<0.001), maximum oxygen consumption (VO2max) (SMD 0.42, 95%CI 0.15-0.68, P=0.002), handgrip force (HGF) (SMD 0.49, 95% CI 0.26–0.73, P<0.001), and quadriceps force (QF) (SMD 0.63, 95% CI 0.45–0.82,P<0.001). There was no significant publication bias in those outcomes mentioned above. CONCLUSIONS PR shows evidence of being an effective adjunctive strategy for improving exercise capacity after lung transplantation, but multi-center trials on larger populations are required to confirm its clinical benefits in the real-world setting. CLINICALTRIAL This meta-analysis protocol was registered with PROSPERO(NO. CRD42023460247)