Grant: Travel Awards - Institute Community Support

In Canada, most lung transplant programs offer mandatory hospital-based pre-transplant exercise programs to optimize fitness and prevent deconditioning in transplant candidates. Home-based programs can give access to rehabilitation to a larger number of patients at lower healthcare costs. Objectives: To describe the changes in functional exercise capacity (6-minute walk distance (6MWD)) in lung transplant candidates who participated in a home-based exercise program and determine the relationship between changes in 6MWD pre and post-transplant variables. Methods: a retrospective cohort study of 119 individuals who received a lung transplant between 2011-2015, participated in a home-based exercise program while waiting list. 6MWD was assessed at 3-time points: time of assessment for transplant, last test prior to transplant and one-month post-transplant. Other variables included: age, sex, primary diagnosis, date of transplantation, body mass index (BMI), total hospital length of stay (LOS), intensive care unit (ICU) LOS and time on mechanical ventilation. Results: LOS on the waiting list=1.8 yrs (median). There was a mean decrease of 17.9±93.9m between the 6MWD at the time of assessment and the last 6MWD prior to surgery (p<0.001; whole sample). Thirty-two patients (26%) increased their 6MWD (mean change 90±42.8m); 50 patients (42%) decreased 6MWD (100±71.2m); and 37 patients (32%) had no change in 6MWD (1±15.7m). There was a weak negative correlation between change in 6MWD prior to transplant and time on mechanical ventilation (r= -0.232; p<0.05). When adjusted for age, gender, BMI, and diagnosis, change in 6MWD prior to transplant was not associated with the time on mechanical ventilation, total hospital or ICU LOS. Conclusion: Most patients (58%) were able to either increase or maintain their 6MWD using a home exercise program while on the waiting list. Home-based semi-supervised exercise programs may be an effective approach prior to transplantation.