Predicting 6-minute walking distance in recipients of lung transplantation: longitudinal study of 108 patients

Edwin van Adrichem, Gerda Reinsma, Sanne van den Berg, Wim van der Bij, Michiel Erasmus, Wim Krijnen, Pieter Dijkstra, Cees van der Schans

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND:

Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally.

OBJECTIVE:

The study aims were to analyze the longitudinal change in 6-minute walking distance and to identify factors contributing to this change.

DESIGN:

This was a longitudinal historical cohort study.

METHODS:

Data from patients who received a lung transplantation between March 2003 and March 2013 were analyzed for the change in 6-minute walking distance and contributing factors at screening, discharge, and 6 and 12 months after transplantation. Linear mixed-model and logistic regression analyses were performed with data on characteristics of patients, diagnosis, waiting list time, length of hospital stay, rejection, lung function, and peripheral muscle strength.

RESULTS:

Data from 108 recipients were included. Factors predicting 6-minute walking distance were measurement moment, diagnosis, sex, quadriceps muscle and grip strength, forced expiratory volume in 1 second (percentage of predicted), and length of hospital stay. After transplantation, 6-minute walking distance increased considerably. This initial increase was not continued between 6 and 12 months. At 12 months after lung transplantation, 58.3% of recipients did not reach the cutoff point of 82% of the predicted 6-minute walking distance. Logistic regression demonstrated that discharge values for forced expiratory volume in 1 second and quadriceps or grip strength were predictive for reaching this criterion.

LIMITATIONS:

Study limitations included lack of knowledge on the course of disease during the waiting list period, type and frequency of physical therapy after transplantation, and number of missing data points.

CONCLUSIONS:

Peripheral muscle strength predicted 6-minute walking distance; this finding suggests that quadriceps strength training should be included in physical training to increase functional exercise capacity. Attention should be paid to further increasing 6-minute walking distance between 6 and 12 months after transplantation.
Original languageEnglish
Pages (from-to)720-729
JournalPhysical therapy
Volume95
Issue number5
DOIs
Publication statusPublished - 2015

Keywords

  • transplantation
  • physiotherapy
  • exercise capacity tests

Cite this

van Adrichem, Edwin ; Reinsma, Gerda ; van den Berg, Sanne ; van der Bij, Wim ; Erasmus, Michiel ; Krijnen, Wim ; Dijkstra, Pieter ; van der Schans, Cees. / Predicting 6-minute walking distance in recipients of lung transplantation : longitudinal study of 108 patients. In: Physical therapy. 2015 ; Vol. 95, No. 5. pp. 720-729.
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abstract = "BACKGROUND: Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally.OBJECTIVE: The study aims were to analyze the longitudinal change in 6-minute walking distance and to identify factors contributing to this change.DESIGN: This was a longitudinal historical cohort study.METHODS: Data from patients who received a lung transplantation between March 2003 and March 2013 were analyzed for the change in 6-minute walking distance and contributing factors at screening, discharge, and 6 and 12 months after transplantation. Linear mixed-model and logistic regression analyses were performed with data on characteristics of patients, diagnosis, waiting list time, length of hospital stay, rejection, lung function, and peripheral muscle strength.RESULTS: Data from 108 recipients were included. Factors predicting 6-minute walking distance were measurement moment, diagnosis, sex, quadriceps muscle and grip strength, forced expiratory volume in 1 second (percentage of predicted), and length of hospital stay. After transplantation, 6-minute walking distance increased considerably. This initial increase was not continued between 6 and 12 months. At 12 months after lung transplantation, 58.3{\%} of recipients did not reach the cutoff point of 82{\%} of the predicted 6-minute walking distance. Logistic regression demonstrated that discharge values for forced expiratory volume in 1 second and quadriceps or grip strength were predictive for reaching this criterion.LIMITATIONS: Study limitations included lack of knowledge on the course of disease during the waiting list period, type and frequency of physical therapy after transplantation, and number of missing data points.CONCLUSIONS: Peripheral muscle strength predicted 6-minute walking distance; this finding suggests that quadriceps strength training should be included in physical training to increase functional exercise capacity. Attention should be paid to further increasing 6-minute walking distance between 6 and 12 months after transplantation.",
keywords = "transplantation, physiotherapy, exercise capacity tests, transplantatie, fysiotherapie, inspanningstests",
author = "{van Adrichem}, Edwin and Gerda Reinsma and {van den Berg}, Sanne and {van der Bij}, Wim and Michiel Erasmus and Wim Krijnen and Pieter Dijkstra and {van der Schans}, Cees",
year = "2015",
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Predicting 6-minute walking distance in recipients of lung transplantation : longitudinal study of 108 patients. / van Adrichem, Edwin; Reinsma, Gerda; van den Berg, Sanne ; van der Bij, Wim; Erasmus, Michiel; Krijnen, Wim; Dijkstra, Pieter; van der Schans, Cees.

In: Physical therapy, Vol. 95, No. 5, 2015, p. 720-729.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Predicting 6-minute walking distance in recipients of lung transplantation

T2 - longitudinal study of 108 patients

AU - van Adrichem, Edwin

AU - Reinsma, Gerda

AU - van den Berg, Sanne

AU - van der Bij, Wim

AU - Erasmus, Michiel

AU - Krijnen, Wim

AU - Dijkstra, Pieter

AU - van der Schans, Cees

PY - 2015

Y1 - 2015

N2 - BACKGROUND: Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally.OBJECTIVE: The study aims were to analyze the longitudinal change in 6-minute walking distance and to identify factors contributing to this change.DESIGN: This was a longitudinal historical cohort study.METHODS: Data from patients who received a lung transplantation between March 2003 and March 2013 were analyzed for the change in 6-minute walking distance and contributing factors at screening, discharge, and 6 and 12 months after transplantation. Linear mixed-model and logistic regression analyses were performed with data on characteristics of patients, diagnosis, waiting list time, length of hospital stay, rejection, lung function, and peripheral muscle strength.RESULTS: Data from 108 recipients were included. Factors predicting 6-minute walking distance were measurement moment, diagnosis, sex, quadriceps muscle and grip strength, forced expiratory volume in 1 second (percentage of predicted), and length of hospital stay. After transplantation, 6-minute walking distance increased considerably. This initial increase was not continued between 6 and 12 months. At 12 months after lung transplantation, 58.3% of recipients did not reach the cutoff point of 82% of the predicted 6-minute walking distance. Logistic regression demonstrated that discharge values for forced expiratory volume in 1 second and quadriceps or grip strength were predictive for reaching this criterion.LIMITATIONS: Study limitations included lack of knowledge on the course of disease during the waiting list period, type and frequency of physical therapy after transplantation, and number of missing data points.CONCLUSIONS: Peripheral muscle strength predicted 6-minute walking distance; this finding suggests that quadriceps strength training should be included in physical training to increase functional exercise capacity. Attention should be paid to further increasing 6-minute walking distance between 6 and 12 months after transplantation.

AB - BACKGROUND: Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally.OBJECTIVE: The study aims were to analyze the longitudinal change in 6-minute walking distance and to identify factors contributing to this change.DESIGN: This was a longitudinal historical cohort study.METHODS: Data from patients who received a lung transplantation between March 2003 and March 2013 were analyzed for the change in 6-minute walking distance and contributing factors at screening, discharge, and 6 and 12 months after transplantation. Linear mixed-model and logistic regression analyses were performed with data on characteristics of patients, diagnosis, waiting list time, length of hospital stay, rejection, lung function, and peripheral muscle strength.RESULTS: Data from 108 recipients were included. Factors predicting 6-minute walking distance were measurement moment, diagnosis, sex, quadriceps muscle and grip strength, forced expiratory volume in 1 second (percentage of predicted), and length of hospital stay. After transplantation, 6-minute walking distance increased considerably. This initial increase was not continued between 6 and 12 months. At 12 months after lung transplantation, 58.3% of recipients did not reach the cutoff point of 82% of the predicted 6-minute walking distance. Logistic regression demonstrated that discharge values for forced expiratory volume in 1 second and quadriceps or grip strength were predictive for reaching this criterion.LIMITATIONS: Study limitations included lack of knowledge on the course of disease during the waiting list period, type and frequency of physical therapy after transplantation, and number of missing data points.CONCLUSIONS: Peripheral muscle strength predicted 6-minute walking distance; this finding suggests that quadriceps strength training should be included in physical training to increase functional exercise capacity. Attention should be paid to further increasing 6-minute walking distance between 6 and 12 months after transplantation.

KW - transplantation

KW - physiotherapy

KW - exercise capacity tests

KW - transplantatie

KW - fysiotherapie

KW - inspanningstests

U2 - 10.2522/ptj.20140001

DO - 10.2522/ptj.20140001

M3 - Article

VL - 95

SP - 720

EP - 729

JO - Physical therapy

JF - Physical therapy

SN - 0031-9023

IS - 5

ER -