Condensed Outpatient Rehabilitation Early after Lung Transplantation: A Retrospective Analysis of 6-Minute Walk Distance and Its Predictors

Purpose: The objectives were to evaluate the effect of a condensed post-lung transplant outpatient rehabilitation program started immediately after hospital discharge on 6-minute walk distance (6MWD) and to explore predictors of change in 6MWD and time to complete rehabilitation. Methods: Data were retrospectively collected from July 2009 to February 2019 on recipients who completed physical therapy-based posttransplant outpatient rehabilitation (PTOR). Changes in 6MWD prerehabilitation to postrehabilitation were assessed using repeated measures, and predictors were assessed using multiple linear regression. Results: Participants (N 5 819, 61% men, 61 years) began PTOR 2 days (interquartile range [IQR] 1–3) after hospital discharge. The mean 6MWD of 324 m (SD 5 107) improved after rehabilitation to 488 m (SD 5 105). Factors associated with improvement were younger age (P 5 .003), higher baseline forced expiratory volume in 1 second (FEV1) (P, .001), and lower baseline 6MWD (P, .001). Participants averaged 22 sessions in 41 days (IQR 35–50); with lower baseline FEV1 (P 5 .002) and 6MWD (P, .001) associated with longer completion time. Conclusions: A condensed outpatient rehabilitation program early after lung transplantation was associated with a large, clinically meaningful improvement in 6MWD. Salient predictors of improvement included age, lung function, and starting 6MWD. These findings from a large cohort of lung transplant recipients who participated in PTOR can assist clinicians in tailoring strategies to optimize patient management.

Duke Scholars

Author Laurie D. Snyder Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Amy Martha Pastva Orthopaedic Surgery, Physical Therapy