Efficacy of Exercise Therapy Initiated in the Early Phase After Kidney Transplantation: A Pilot Study

Abstract

In patients with kidney transplant (KT), frailty is a predictor of adverse outcomes. Outcomes of exercise therapy in patients with KT, particularly the efficacy of early exercise after KT, have not been evaluated. We investigated the effect of exercise intervention beginning early after KT on physical performance, physical activity, quality of life, and kidney function in patients with KT. KT recipients who underwent surgery with usual care plus exercise training from a prospective cohort (exercise group; n=10) and those with usual care alone from a historical cohort (control group; n=14) were included in this study. Early exercise comprised supervised aerobic training and physical activity instruction from day 6 to 2months after KT. The following outcomes were measured: 6-minute walking distance, isometric knee extensor strength, gait speed, physical activity, quality of life, and estimated glomerular filtration rate. Analyses of covariance, adjusted for baseline values, revealed significant mean differences between exercise and control groups at 2months after KT in 6-minute walking distance (+44.4m, P=.03) and isometric knee extensor strength (+8.1%body weight, P=.03). No significant between-group differences were found in gait speed, physical activity, and quality of life. The analysis of variance for comparison of the area under the recovery curves of estimated glomerular filtration rate after KT revealed no significant difference between groups. Supervised aerobic training and physical activity instruction initiated in the early phase after KT can improve physical performance without adversely affecting kidney function.