Virtual home-based pre-habilitation program in lung transplant candidates

Background: Pre-habilitation may help lung transplant candidates improve or maintain their physical function during the waiting time for transplant. Telerehabilitation may enhance patient monitoring and adherence. Objective: To estimate the extent to which a 12-week virtual pre-habilitation program affects exercise capacity, frailty, lower limb strength and health-related quality of life (HRQL) in lung transplant candidates. Methods: Design: single-arm prospective longitudinal study. The 12-week virtual pre-habilitation program offered supervised strengthening exercises through a video conferencing platform and independent aerobic exercises. The primary outcome was six-minute walk distance (6MWD). Secondary outcome measures: Short Physical Performance Battery (SPPB), five-times sit-to-stand test (5STS), the St George’s Respiratory Questionnaire (SGRQ), adherence and adverse events. Results: Twenty lung transplant candidates were included; fourteen completed the pre-habilitation program. There was no statistically significant improvement in 6MWD. However, most patients either maintained (N=8) or improved (N=3) their walking distance. There was a statistically significant improvement in the 5STS (10.0 ± 2.6 vs 8.6 ± 2.0 seconds, p=0.009). There was no statistically significant improvement in the SPPB, but patients either maintained (N=10) or improved (N=4) their score. There was no statistically significant improvement in the SGRQ. Participants attended more than 90% of the virtual sessions. There were no adverse events. Conclusion: Lung transplant candidates can improve their lower limb strength and maintain their exercise capacity and frailty status after participating in a 12-week virtual pre-habilitation program.