Journal
CLINICAL TRANSPLANTATION
Volume 35, Issue 4, Pages -Publisher
WILEY
DOI: 10.1111/ctr.14236
Keywords
lung disease; lung transplantation; quality of life; rehabilitation
Categories
Funding
- Penn Center for Precision Medicine at the University of Pennsylvania
- National Institutes of Health [R01 HL134851]
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The study evaluated the feasibility, safety, and efficacy of a mHealth-supported physical rehabilitation intervention for frail lung transplant recipients. Utilization of the mHealth rehabilitation platform was found to be safe and well received, resulting in improvements in frailty, physical activity, and disability levels.
We evaluated the feasibility, safety, and efficacy of a mHealth-supported physical rehabilitation intervention to treat frailty in a pilot study of 18 lung transplant recipients. Frail recipients were defined by a short physical performance battery (SPPB score <= 7). The primary intervention modality was Aidcube, a customizable rehabilitation mHealth platform. Our primary aims included tolerability, feasibility, and acceptability of use of the platform, and secondary outcomes were changes in SPPB and in scores of physical activity, and disability measured using the Duke Activity Status Index (DASI) and Lung Transplant-Value Life Activities (LT-VLA). Notably, no adverse events were reported. Subjects reported the app was easy to use, usability improved over time, and the app enhanced motivation to engage in rehabilitation. Comments highlighted the complexities of immediate post-transplant rehabilitation, including functional decline, pain, tremor, and fatigue. At the end of the intervention, SPPB scores improved a median of 5 points from a baseline of 4. Physical activity and patient-reported disability also improved. The DASI improved from 4.5 to 19.8 and LT-VLA score improved from 2 to 0.59 at closeout. Overall, utilization of a mHealth rehabilitation platform was safe and well received. Remote rehabilitation was associated with improvements in frailty, physical activity and disability. Future studies should evaluate mHealth treatment modalities in larger-scale randomized trials of lung transplant recipients.
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