Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach

Abstract

Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and post-transplant patient care and rehabilitation researchers.

Keywords: Exercise training; Lung transplantation; Physical activity; Physical therapy; Rehabilitation.

Figure 1

Overview of rehabilitation during the pre- and post-transplant phases. At each phase, monitoring and re-assessment are needed to modify/progress the exercise program. ¹Some hospitalized lung transplant candidates and recipients may require mechanical ventilation and/or extracorporeal life support (ECLS) and can be mobilized on these devices. FITT-P: Frequency, intensity, type, time, progression; ICU: Intensive care unit.