Solid Organ Transplant Recipients' Opinions of Pre- and Post-Transplant Supervised Exercise Programmes: A Brief Report

Abstract

Purpose: Access to pre-and post-transplant supervised exercise programmes in Canada is not consistent across organ types. The opinions of solid organ transplant (SOT) recipients can contribute to the discussion among stakeholders regarding increasing the availability of supervised exercise programmes. The objective of the study was to determine Canadian SOT recipients' opinions of pre-and post-transplant supervised exercise programmes and the factors that influenced their participation. Method: An Internet-based questionnaire was distributed to members of the Canadian Transplant Association. It was part of a larger survey and examined seven items related to accessibility to, and opinion of, supervised exercise programmes. Results: A total of 35% (n ¼ 39) of respondents had attended a pre-transplant exercise programme, and 54% (n ¼ 61) had attended a post-transplant exercise programme. The majority of participants believed that a supervised exercise programme was beneficial to health and well-being. Perception of benefits, a physician's recommendation, and health status and symptoms were key influencing factors in the decision of whether to attend a pre-or post-transplant exercise programme. Conclusion: SOT recipients had positive opinions of supervised exercise programmes despite unequal access among organ groups. Some key influencing factors (e.g., a physician's recommendation) are modifiable and should be taken into consideration to encourage participation in such programmes.Key Words: availability of health services; exercise; rehabilitation; organ transplantation; survey. RÉ SUMÉObjectif : l'accè s à un programme d'exercice supervisé avant et aprè s une greffe au Canada est iné gal selon le type d'organe. L'opinion des personnes ayant reç u une greffe d'organe plein (GOP) peut enrichir les discussions des intervenants concernant l'augmentation de l'offre de tels programmes. Cette é tude vise à dé terminer l'opinion des greffé s sur les programmes d'exercice supervisé s avant et aprè s la greffe et les facteurs qui ont influencé leur participation. Mé thodes : un questionnaire en ligne a é té envoyé aux membres de l'Association canadienne des greffé s. Ce questionnaire faisait partie d'un sondage plus vaste et portait sur sept aspects lié s à l'accessibilité des programmes d'exercice supervisé s et à l'opinion à leur é gard. Ré sultats : au total, 35 % (n ¼ 39 ) des ré pondants avaient participé à un programme d'exercice avant leur greffe, et 54 % (n ¼ 61) avaient participé à un programme aprè s leur greffe. La majorité des participants é tait d'avis qu'un programme d'exercice supervisé avait des bienfaits sur la santé et le bien-ê tre. La dé cision de participer ou non à un programme d'exercice avant ou aprè s la greffe é tait influencé e par les facteurs suivants : la perception des bienfaits, la recommandation d'un mé decin ainsi que l'é tat de santé et les symptô mes. Conclusion : les personnes ayant reç u une GOP ont une opinion favorable des programmes d'exercice supervisé s malgré l'iné galité ...

Physical activity and renal function in the Italian kidney transplant population

“…For the transplant community, these findings can be a spur to elaborate further interventions on sedentary lifestyle before and after transplantation [51,52] and lead us to ponder about how to overcome barriers to PA [31,[53][54][55][56] in the most fragile patients (elderly, longterm dialysis). The lack of specific counseling by physicians about the benefits of PA could be a critical issue, and recommendations alone may be not sufficient to induce actual lifestyle changes [59][60][61][62][63][64][65][66][67]. Development of regional and national networks with multidisciplinary teams may constitute an important starting point to promote the spread of territorial programs of PA (supervised or unsupervised exercise) [20,[60][61][62][63][64][65][66][67]; the availability of the national registry represents an added value for verify and monitor their efficacy.…”

Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

“…Compliance with the treatment is a common barrier of health programmes based on exercise even if transplant recipients who have experienced a supervised exercise programme supported that it was beneficial to health and well-being[ 24 ]. Social, cognitive, personality, environmental, and socio-economic factors, unrelated to the recommended guidelines, seem to be of greater importance in considering behavioural adherence issues[ 25 ] in KTRs.…”

Physical Activity Behaviour in Solid Organ Transplant Recipients: Proposal of Theory-Driven Physical Activity Interventions

“…The barriers and motivators were classified according to COM-B and TDF (Table 4) and subsequently embedded and discussed below according to the context dimension of CICI. The identified barriers and motivators were related to participation in physical activity and/or exercise [8,11,54,[69][70][71][72][73][74][75][76][77][78][79], exercise-based rehabilitation [80][81][82][83], or participation in the World Transplant Games [84]. The terms physical activity and exercise were often used interchangeably, making it impossible to make a clear distinction between these variables.…”

“…Knowledge Patients (and health care providers) require the knowledge about why, how, when, how often, and with who to be physically activity in a safe way Evaluated in 9/19 records Lack of knowledge about the benefits of physical activity [11,69] (K/M) Lack of knowledge about appropriate exercise [74] or unsure how to exercise safely [81] (K/M) Health care providers' lack of expertise, lack of medical clearance, lack of specific advice, and conflicting or vague advice [11,71,74,77,84] (K/Li/M) Health care providers not recommending or advising against physical activity [79,80] (K/M) Health care providers not providing answers on questions about exercise limitations [74] (K) Desire for (currently lacking) exercise guidelines [74] (K)Desire to three different types of guidance: (i) standardized guidance, (ii) prescriptive (individualized) guidance, and (iii) supervised guidance/sessions both individual and in group [74] (K) Exercise advice and guidance not priority of the National Health Service (UK) [74] (K) Evaluated in 7/19 records Knowing the value and benefits of increased PA [69,79] (K) Having knowledge about PA [72] (M) Receiving information on how to exercise [69] (K) Expertise of personnel [11] (M) Physician recommendations to PA [72,80] (M) Individualized timely advice consistent across the multidisciplinary team [71] (Li) Accessible and comprehensive rehabilitation as a potential source for guidelines around proper exercise and transplant appropriate milestones [77] (M)…”

“…Five studies (six records) focused solely on kidney transplant recipients (n = 741) [69,70,74,75,79,82], one study on liver transplant recipients (n = 13) [71], one study on heart transplant recipients (n = 8) [83], one study on lung transplant recipients (n = 111) [73], and one study did not specify the transplant population (n = 13) [54]. Eight independent studies (nine records) evaluated barriers and motivators in cohorts of various organ transplant recipients, i.e., 531 kidney transplant recipients, 250 liver transplant recipients, 148 lung transplant recipients, 114 heart transplant recipients, and four multi-organ transplant recipients [8,11,72,[76][77][78]80,81,84]. Based on limited literature data, there are no differences in barriers and motivators between different solid organ transplant groups [11,76].…”