Exercise training following lung transplant is now evidence-based practice
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Résumé
QUESTION: In patients immediately following lung transplant, does three months of supervised exercise training confer changes in physical activity during daily life, functional exercise capacity, muscle force, health-related quality of life (HRQL), or forced expiratory volume in one second (FEV(1))? DESIGN: Randomised, controlled trial with concealed allocation in which investigators responsible for collecting the outcome measures were blinded to group allocation. SETTING: Out-patient department of a hospital in Leuven, Belgium. PARTICIPANTS: Patients aged between 40 and 65 years who had an uncomplicated single or double lung transplant. Randomisation of 40 participants allocated 21 to the intervention group and 19 to the control group. INTERVENTIONS: Participants in both groups received six individual counselling sessions of 15-30 minutes in duration, during which they were instructed to increase participation in daily physical activity. In addition, the intervention group attended supervised exercise training sessions three times a week for 3 months following discharge. Each training session was approximately 90 minutes and comprised cycle ergometry, walking, stair climbing, and leg press resistance exercises. Training was prescribed at moderate to high intensity and progressed according to symptoms. OUTCOME MEASURES: The primary outcome was time spent walking each day. Secondary outcomes included the six-minute walk distance (6MWD), peripheral muscle force, HRQL, and FEV(1). RESULTS: Data were available on 18 and 16 patients in the intervention and control groups, respectively. On completion of the intervention, between-group differences in favour of the intervention group were demonstrated in the average time spent walking each day (difference in means 14 min, 95% CI 4 to 24), 6MWD (differences in means 9% predicted, 95% CI 3 to 15) and quadriceps force (difference in means 17% predicted, 95% CI 9 to 24), but not HRQL or FEV(1). These between-group differences were maintained 12 months following discharge from hospital. At the 12 month assessment, between-group differences in favour of the intervention group were also demonstrated in two components of HRQL related to physical function. CONCLUSION: In patients following lung transplant, exercise training conferred immediate and sustained gains in physical activity during daily life and exercise capacity. Gains in HRQL also appear to be evident, but took longer to be realised.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle