Benefits of home-based endurance training in lung transplant recipients.

Background: To investigate the effect of home-based exercise training on exercise tolerance, muscle function and quality of life in lung transplant recipients (LTR). Methods: Twelve LTR and 7 age-matched healthy subjects underwent exercise training (ET, 12-wk, 3x/wk, 40 min). Peak aerobic capacity ((V) over dotO(2peak)), endurance time (T-end), minute ventilation ((V) over dot(E)) quadriceps strength, percentage of type I fiber (%Ifb), fiber diameters and chronic respiratory questionnaire were assessed before and after ET. A positive response to ET was defined as an improvement in T-end at least comparable to the mean change observed in healthy subjects. Results: Training significantly improved T-end (+12 +/- 11 min), isowatt during exercise (-5.5 +/- 2.6 L/min), muscle strength (+4.6 +/- 2.6 kg) and dyspnea score (+0.6 +/- 0.9) in LTR (p < 0.05), leading to recovery of T-end and muscle strength up to healthy subjects' values. In responders (n = 6), (V) over dotO(2peak). %Ifb and fatigue score were improved after training (p < 0.05). Non-responders had lower %Ifb and greater delay between surgery and the beginning of the study than responders (56 [21-106] vs. 8 [2-59] months respectively, p = 0.03). Conclusions: Home-based ET was effective to improve exercise tolerance, muscle strength and quality of life in LTR but more successful in patients with moderate muscle dysfunction and in the first years after transplantation. Multicenter and controlled-studies are needed to confirm the benefits and optimal modalities of home training in LTR. (C) 2011 Published by Elsevier B.V.