Group Versus Individual Rehabilitation in Lung Transplantation: A Retrospective Noninferiority Assessment

Author:

Byrd Rebecca1,Breslin Rachel1,Wang Peijin2,Peskoe Sarah2,Chow Shein-Chung2,Lowers Sean1,Snyder Laurie D.34,Pastva Amy M.356

Affiliation:

1. Department of Cardiology, Duke University Health System, Durham, NC

2. Department of Biostatistics and Bioinformatics, Duke University, Durham NC

3. Department of Medicine, Duke University, Durham NC

4. Duke Clinical Research Institute, Durham, NC

5. Division of Physical Therapy, Department of Orthopedic Surgery, Duke University, Durham, NC

6. Claude D. Pepper Older Americans Independence Center, Duke University School of Medicine, Durham, NC

Abstract

Purpose: Pulmonary rehabilitation both before and after lung transplant is associated with improved functional exercise capacity and physical quality of life. There is wide variation in rehabilitation program provision. This study's aim was to compare the effects of group versus individual rehabilitation. Methods: Individuals who completed pre- and/or posttransplant outpatient rehabilitation at a single, academic, medical center between March 2019 and March 2021 were included in this study. Noninferiority analysis was used to assess differences in change in 6-minute walk distance (6MWD) between group and individual rehabilitation. Multivariable linear regression models examined 6MWD, Short Physical Performance Battery (SPPB), Ferrans and Powers Quality of Life Index Pulmonary Version (QLI), Center for Epidemiological Studies-Depression Scale (CESD), and San Diego Shortness of Breath Questionnaire (SOBQ). Results: Preoperatively, 93 patients completed group and 81 completed individual rehabilitation. Postoperatively, 110 completed group and 105 completed individual rehabilitation. Individual rehabilitation was noninferior to group rehabilitation (α = 0.05). In addition, there was no significant difference in changes in 6MWD, SPPB, QLI, CESD, or SOBQ, between cohorts pre- and postoperatively (all P > .25). Conclusions: Individual rehabilitation seems to be an acceptable alternative to group rehabilitation for lung transplant candidates and recipients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physical Therapy, Sports Therapy and Rehabilitation

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1. New Year, New Challenges;Cardiopulmonary Physical Therapy Journal;2024-01

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