The Effect of a Comprehensive Rehabilitation Program on Respiratory Function and Functional Capacity on Patients After 1 Month to Liver Transplantation

Abstract

Physical exercise is prescribed in populations with chronic diseases, but data are scarce in the liver transplantation (LT) setting. The aim of this study was to evaluate changes in forced expiratory volume in the first second, forced vital capacity, maximal inspiratory pressure, maximal expiratory pressure, 6-minute walking test (6MWT), 6-minute step test (6MST), Duke Activity Status Index, VO2 (mL/kg/min), and health-related quality of life (in patients submitted to a rehabilitation program, comprising physical exercise training, breathing techniques, and educational sessions after LT. This cohort study enrolled patients to an 8-week period of thrice weekly comprehensive supervised rehabilitation program after 1 month of LT. A nonrandomized control cohort of LT patients were selected to match the rehabilitation group based on specific demographic data and severity of disease. The rehabilitation group, compared with the control group, showed a significant improvement in respiratory parameters (forced vital capacity [0.33L vs 0.13L,P < .01]); exercise capacity (6MWT and 6MST 71.1 vs 34.1 meters; and 30.5 vs 7.5 steps; respectively P < .01); Duke Activity Status Index scores and VO2 (21.3 vs 10.2 and 9 vs 4.3; respectively P < .01); respiratory muscle strength (maximal inspiratory pressure 21.1 vs 15.1 cmH2O and maximal expiratory pressure 21.2 vs 10.2 cmH2O; P < .01); and quality of life (SF-36 physical component summary 12.4 vs 2.9 P < .01). These data suggest that improvements in physical fitness, respiratory parameters, and quality of life are achieved with a comprehensive rehabilitation program initiated early after LT.