Transplant Trial Watch

Longer Versus Shorter Duration of Rehabilitation Following Lung Transplantation: A Randomised Trial.

Fuller LM, Button B, et al.

Archives of Physical Medicine and Rehabilitation 2016 [record in progress].


Aims
To determine the effects of a supervised long duration versus short duration rehabilitation program after lung transplantation (LTX).

Interventions
Participants were randomly allocated to receive either a short duration (7-week) or long duration (14-week) rehabilitation program.

Participants
66 double or single LTX recipients aged ≥ 18 years.

Outcomes
The primary outcome measured was the six minute walk test (6MWT). Secondary measured outcomes included isokinetic dynamometry and health-related quality of life (HRQOL).

Follow-up
6 months

CET Conclusions
This well-conducted trial compared a short (7-week) versus long (14-week) outpatient rehabilitation programme for lung transplant recipients. During the first 7 weeks all patients attended three, 1-hour sessions per week supervised by a physiotherapist and allied health assistant who were blinded to the allocation. They also attended the same education sessions that promoted self-management and independence. Participants allocated to the short programme were encouraged at the end of the 7 weeks to continue exercising at home in line with the long programme and were contacted weekly by the researcher to check on progress. Participants were allocated according to a computer-generated sequence and allocation was concealed by the use of opaque envelopes. Sixty-six participants were required to detect a minimally clinically important difference on the 6-minute walk test at 6 months with 81% probability. Missing data were not imputed in the intent-to-treat analysis, which included 64 out of the total 66 patients. There was a significant improvement in the 6-minute walk test for both groups but no difference between groups at 7 and 14 weeks, and 6 months, which may be due to the fact that participants in the short-programme group were encouraged to continue exercising. Upper limb strength, lower limb strength and quality of life (physical and mental health) were also significantly improved over time but again did not show differences between groups.

Jadad score
3

Data analysis
Available case analysis

Allocation concealment
Yes

Trial registration
Australian and New Zealand Clinical Trial Registry (ANZCTR) - 12611000644965

Funding source
Non-industry funded