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The effect of exercise training interventions in adult kidney transplant recipients: a systematic review and meta-analysis of randomised control trials

journal contribution
posted on 05.11.2021, 08:46 by Thomas Wilkinson, Nicolette BishopNicolette Bishop, Roseanne Billany, Courtney Lightfoot, Ellen Castle, Alice Smith, Sharlene Greenwood
Background
Kidney transplant recipients (KTRs) are characterised by adverse changes in physical fitness and body composition. Post-transplant management involves being physically active, although evidence for the effect of exercise is limited.
Objective
To assess the effects of exercise training interventions in KTRs.
Methods
NCBI PubMed (MEDLINE) and CENTRAL (EMBASE, WHO ICTRP) databases were searched up to March 2021 to identify eligible randomized controlled trials (RCTs) that studied exercise training in adult KTRs. Outcomes included exercise capacity, strength, blood pressure, body composition, heart rate, markers of dyslipidaemia and renal function, and health-related quality of life (QoL).
Results
Sixteen RCTs, containing 827 KTRs, were included. The median intervention length was 14-50 weeks with participants exercising between 2-7x/week. Most studies used a mixture of aerobic and resistance exercise. Significant improvements were observed in cardiorespiratory function (VO2peak) (3.21 ml/kg/min, P=0.003), 6MWT (76.3 meters, P=0.009), physical function (STS-60, 4.8 repetitions, P=0.04), and high-density lipoprotein (HDL) (0.13 mg/dL, P=0.03). A moderate increase in maximum heart rate was seen (P=0.06). A moderate reduction in creatinine was also observed (0.14 mg/dl, P=0.05). Isolated studies reported improvements in strength, bone health, lean mass, and QoL. Overall, studies had high risk of bias suggestive of publication bias.
Conclusions
Exercise training may confer several benefits in adult KTRs, particularly by increasing cardiorespiratory function and exercise capacity, strength, HDL levels, maximum heart rate, and improving QoL. Additional long-term large sampled RCTs, incorporating complex interventions requiring both exercise and dietary behaviour change, are needed to fully understand the effects of exercise in KTRs.

History

School

  • Sport, Exercise and Health Sciences

Published in

Physical Therapy Reviews

Publisher

Taylor & Francis

Version

AM (Accepted Manuscript)

Publisher statement

This is an Accepted Manuscript of an article published by Taylor & Francis in Physical Therapy Reviews on [date of publication], available online: http://www.tandfonline.com/[Article DOI].

Acceptance date

02/11/2021

ISSN

1083-3196

eISSN

1743-288X

Language

en

Depositor

Prof Lettie Bishop. Deposit date: 4 November 2021

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