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

Table 1 Physical assessment of lung transplant candidates and recipients

Measuredconstruct	Clinical tests	Clinical utility
Exercise capacity	Lab-based test: Cardiopulmonary exercise test on cycle or treadmill Field-based walk tests: 6MWT, ISWT[19,27] Upper extremity endurance capacity: UULEX[28]	Cause of exercise limitation Assess need for oxygen Assess functional capacity Outcome measure pre-post rehab and pre-post transplant Exercise prescription
Muscle function (strength, endurance)	Peripheral muscles: Manual muscle testing or hand held dynamometry Handgrip force 1-repetition maximum Respiratory muscles: MIP/MEP	Assess muscle strength and/or muscle endurance Outcome measure Exercise prescription (1-RM for peripheral muscles, MIP for IMT)
Physical performance and mobility	Gait speed (over 4 m)[110] Sit-stand tests (e.g., 30 s sit to stand; 5 times sit to stand)[111,112] Short Physical Performance Battery[113] Timed Up and Go[114] Balance tests (e.g., Berg balance scale, BESTest)[115,116] FIM[117] Tests specifically for ICU/inpatients: Egress test[118] Various ICU physical function tests[119-121]	Assess mobility, balance and physical function Assess need for gait aid Outcome measure Exercise prescription Discharge planning
Physical activity	Physical Activity questionnaires, e.g., PASE[122]; IPAQ[123]; DASI[124] Pedometers or accelerometers	Assess physical activity Outcome measure Set activity goals (e.g., target daily step count)

CPET: Cardiopulmonary exercise test; 6MWT: Six-minute walk test; ISWT: Incremental shuttle walk test; UULEX: Unsupported upper limb exercise test; MMT: Manual muscle testing; 1RM: One repetition maximum; HGF: Handgrip force; HHD: Hand-held dynamometry; MIP: Maximal inspiratory pressure, MEP: Maximal expiratory pressure; IMT: Inspiratory muscle testing; SPPB: Short physical performance battery; TUG: Timed Up and Go; FIM: Functional independence measure; PASE: Physical activity scale for the elderly; IPAQ: International physical activity questionnaire; DASI: Duke activity status questionnaire.