Knols RH1, Fischer N1,2, Kohlbrenner D3, Manettas A3, de Bruin ED2,4
1University Hospital Zurich, Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, Zurich, Switzerland, 2ETH Zurich, Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, Zurich, Switzerland, 3University Hospital Zurich, Department of Physiotherapy and Occupational Therapy, Zurich, Switzerland, 4Karolinska Institute, Division of Physiotherapy, Department of Neurobiology, Stockholm, Sweden
Background: Comparing exercisers and non-exercisers after lung transplantation (LTx), evidence is available supporting structured exercise programs to improve maximal exercise capacity, physical function, muscle strength and bone mineral density. Only if exercise programs are documented in sufficient detail, their replication can be warranted, and clinicians and researchers are enabled to apply these effective interventions.
Purpose: This systematic review aimed to assess the replicability of physical exercise interventions in LTx patients. For replicability, we focused on
(1) the description of training principles,
(2) the description of FITT components and adherence to the interventions,
(3) the amount of detailed information given on the physical exercise intervention, and
(4) reporting of the methodological quality of the included works.
Methods: Relevant databases (Medline-Ovid, EMBASE, CINAHL, PsycINFO, Cochrane Library) were searched for RCTs meeting the inclusion criteria. Author dyads selected and systematically analyzed the included studies independently from each other. A purpose-developed checklist was used to assess the details of the exercise interventions and their methodological Quality.
Results: From the seven included manuscripts, three described resistance training, one endurance, and three combined training approaches. All manuscripts reported specificity and initial values, six manuscripts mentioned progression and overload. The exercise principle reversibility was reported once and diminishing returns was not reported at all. All studies reported the type of exercise, three studies reported intensity and one study reported time for training. Not any study completely reported frequency or described adherence to the intervention. Lack of detailed reporting was identified as the cause for murky description of the interventions. The highest score for intervention description was 5 of possible 12 items.
Conclusion(s): Replicability of many exercise interventions in LTx is not warranted due to poor descriptions of important items related to training. In particular there were insufficiently detailed reporting of training principles and FITT components in programs developed for LTx.
Implications: Future interventions aiming to train LTx patients should spend effort in writing reports in which the intervention is detailed to such an extent that full replicability in clinical settings can be guaranteed.
Keywords: lung transplant, systematic review, exercise
Funding acknowledgements: This systematic Review received no funding.
Purpose: This systematic review aimed to assess the replicability of physical exercise interventions in LTx patients. For replicability, we focused on
(1) the description of training principles,
(2) the description of FITT components and adherence to the interventions,
(3) the amount of detailed information given on the physical exercise intervention, and
(4) reporting of the methodological quality of the included works.
Methods: Relevant databases (Medline-Ovid, EMBASE, CINAHL, PsycINFO, Cochrane Library) were searched for RCTs meeting the inclusion criteria. Author dyads selected and systematically analyzed the included studies independently from each other. A purpose-developed checklist was used to assess the details of the exercise interventions and their methodological Quality.
Results: From the seven included manuscripts, three described resistance training, one endurance, and three combined training approaches. All manuscripts reported specificity and initial values, six manuscripts mentioned progression and overload. The exercise principle reversibility was reported once and diminishing returns was not reported at all. All studies reported the type of exercise, three studies reported intensity and one study reported time for training. Not any study completely reported frequency or described adherence to the intervention. Lack of detailed reporting was identified as the cause for murky description of the interventions. The highest score for intervention description was 5 of possible 12 items.
Conclusion(s): Replicability of many exercise interventions in LTx is not warranted due to poor descriptions of important items related to training. In particular there were insufficiently detailed reporting of training principles and FITT components in programs developed for LTx.
Implications: Future interventions aiming to train LTx patients should spend effort in writing reports in which the intervention is detailed to such an extent that full replicability in clinical settings can be guaranteed.
Keywords: lung transplant, systematic review, exercise
Funding acknowledgements: This systematic Review received no funding.
Topic: Cardiorespiratory; Research methodology & knowledge translation; Disability & rehabilitation
Ethics approval required: No
Institution: Swissethics
Ethics committee: KEK Zurich
Reason not required: Not necessary for Systematic Reviews
All authors, affiliations and abstracts have been published as submitted.
