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Effect of Upper Limb Rehabilitation Compared to No Upper Limb Rehabilitation in Lung Transplant Recipients: A Randomized Controlled Trial

Published:October 14, 2017DOI:https://doi.org/10.1016/j.apmr.2017.09.115

      Abstract

      Objective

      To investigate the effect of a supervised upper limb (UL) program (SULP) compared to no supervised UL program (NULP) after lung transplantation (LTx).

      Design

      Randomized controlled trial.

      Setting

      Physiotherapy gym.

      Participants

      Participants (N=80; mean age, 56±11y; 37 [46%] men) were recruited after LTx.

      Interventions

      All participants underwent lower limb strength thrice weekly and endurance training. Participants randomized to SULP completed progressive UL strength training program using handheld weights and adjustable pulley equipment.

      Main Outcome Measures

      Overall bodily pain was rated on the visual analog scale. Shoulder flexion and abduction muscle strength were measured on a hand held dynamometer. Health related quality of life was measured with Medical Outcomes Study 36-item Short Form health Survey and the Quick Dash. Measurements were made at baseline, 6 weeks, 12 weeks, and 6 months by blinded assessors.

      Results

      After 6 weeks of training, participants in the SULP (n=41) had less overall bodily pain on the visual analog scale than did participants in the NULP (n=36) (mean VAS bodily pain score, 2.1±1.3cm vs 3.8±1.7cm; P<.001) as well as greater UL strength than did participants in the NULP (mean peak force, 8.4±4.0Nm vs 6.7±2.8Nm; P=.037). At 12 weeks, participants in the SULP better quality of life related to bodily pain (76±17 vs 66±26; P=.05), but at 6 months there were no differences between the groups in any outcome measures. No serious adverse events were reported.

      Conclusions

      UL rehabilitation results in short-term improvements in pain and muscle strength after LTx, but no longer-term effects were evident.

      Keyword

      List of abbreviations:

      BAT (bilateral anterior thoracotomy), BSLTx (bilateral sequential lung transplant), CSI (clamshell incision), LTx (lung transplantation), NULP (no supervised upper limb program), QOL (quality of life), SULP (supervised upper limb program), UL (upper limb), VAS (visual analog scale)
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