Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Sep 24, 2016; 6(3): 517-531
Published online Sep 24, 2016. doi: 10.5500/wjt.v6.i3.517
Physical rehabilitation for lung transplant candidates and recipients: An evidence-informed clinical approach
Lisa Wickerson, Dmitry Rozenberg, Tania Janaudis-Ferreira, Robin Deliva, Vincent Lo, Gary Beauchamp, Denise Helm, Chaya Gottesman, Polyana Mendes, Luciana Vieira, Margaret Herridge, Lianne G Singer, Sunita Mathur
Lisa Wickerson, Dmitry Rozenberg, Gary Beauchamp, Denise Helm, Chaya Gottesman, Margaret Herridge, Lianne G Singer, Toronto Lung Transplant Program, University Health Network, Toronto, ON M5G 2N2, Canada
Lisa Wickerson, Vincent Lo, Gary Beauchamp, Denise Helm, Chaya Gottesman, Rehabilitation Services, University Health Network, Toronto, ON M5G 2C4, Canada
Lisa Wickerson, Sunita Mathur, Department of Physical Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada
Lisa Wickerson, Sunita Mathur, Rehabilitation Sciences Institute, University of Toronto, Toronto, ON M5G 1V7, Canada
Tania Janaudis-Ferreira, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec H3G 1Y5, Canada
Tania Janaudis-Ferreira, Sunita Mathur, Canadian National Transplant Research Program, Edmonton, Alberta T6G 2E1, Canada
Robin Deliva, Department of Physiotherapy, Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
Polyana Mendes, Department of General Surgery/Gastroenterology/Plastics, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
Luciana Vieira, Health Sciences and Technologies PhD Program, University of Brasilia, DF 72220-275, Brazil
Margaret Herridge, Lianne G Singer, Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
Author contributions: Wickerson L and Mathur S originally conceived the concept and design of the paper; all authors contributed to the literature review, clinical content, drafting, critical revision and editing, and approval of the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest and no financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sunita Mathur, BScPT, MSc, PhD, Department of Physical Therapy, University of Toronto, 160-500 University Ave, Toronto, ON M5G 1V7, Canada. sunita.mathur@utoronto.ca
Telephone: +1-416-9787761 Fax: +1-416-9468562
Received: April 28, 2016
Peer-review started: April 28, 2016
First decision: June 16, 2016
Revised: July 31, 2016
Accepted: August 17, 2016
Article in press: August 18, 2016
Published online: September 24, 2016
Processing time: 148 Days and 14.5 Hours
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: Lung transplantation; Rehabilitation; Physical therapy; Exercise training; Physical activity

Core tip: This expert review brings together clinical experience and research evidence on physical rehabilitation for lung transplant candidates and recipients. The evaluation of exercise capacity, muscle function, mobility, activities of daily living and physical activity is discussed. Rehabilitation training guidelines for pre-transplant, acute care, early and late post-transplant phases are provided with special attention to complicated and uncomplicated clinical courses. Special populations such as heart-lung transplant and paediatric lung transplant are also included.