Affiliation:
1. Department of Pediatrics University of Alberta Edmonton Alberta Canada
2. Canadian Donation and Transplant Research Program Edmonton Alberta Canada
3. Alberta Transplant Institute Edmonton Alberta Canada
4. School of Rehabilitation Therapy Queen's University Kingston Ontario Canada
5. Department of Pediatrics, Alberta Children's Hospital Research Institute, Cumming School of Medicine University of Calgary Calgary Alberta Canada
6. Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine University of Calgary Calgary Alberta Canada
7. British Columbia Children's Hospital Research Institute Vancouver British Columbia Canada
Abstract
AbstractBackgroundPediatric heart (HTx) and kidney transplant (KTx) recipients may have lower physical fitness than healthy children. This study sought to quantify fitness levels in transplant recipients, investigate associations to clinical factors and quality of life, and identify whether a quick, simple wall‐sit test is feasible as a surrogate for overall fitness for longitudinal assessment.MethodsAerobic capacity (6‐min walk test, 6MWT), normalized muscle strength, muscle endurance, physical activity questionnaire (PAQ), and quality of life (PedsQL™) were prospectively assessed in transplanted children and matched healthy controls.ResultsTwenty‐two HTx were compared to 20 controls and 6 KTx. 6MWT %predicted was shorter in HTx (87.2 [69.9–118.6] %) than controls (99.9 [80.4–120] %), but similar to KTx (90.3 [78.6–115] %). Muscle strength was lower in HTx deltoids (6.15 [4.35–11.3] kg/m2) and KTx quadriceps (9.27 [8.65–19.1] kg/m2) versus controls. Similarly, muscle endurance was lower in HTx push‐ups (28.6 [0–250] %predicted), KTx push‐ups (8.35 [0–150] %predicted), HTx curl‐ups (115 [0–450] %predicted), and KTx wall‐sit time (18.5 [10.0–54.0] s) than controls. In contrast to HTx with only 9%, all KTx were receiving steroid therapy. The wall‐sit test significantly correlated with other fitness parameters (normalized quadriceps strength R = .31, #push‐ups R = .39, and #curl‐ups R = .43) and PedsQL™ (R = .36).ConclusionsCompared to controls, pediatric HTx and KTx have similarly lower aerobic capacity, but different deficits in muscle strength, likely related to steroid therapy in KTx. The convenient wall‐sit test correlates with fitness and reported quality of life, and thus could be a useful easy routine for longitudinal assessment.