Rehabilitation Clinical Trial
Official title:
Post-operative, Inpatient Rehabilitation After Lung Transplant Evaluation: A Feasibility Study
This randomized, feasibility trial (n=40) will compare the effects of an intensive, twice daily inpatient physical rehabilitation program against standard care (once daily) following double lung transplantation.
This trial will involve the participation of patients post lung transplantation, in the
initial post-operative period. Recruitment will take place as soon as the patient is
medically safe and willing to commence physical rehabilitation within the intensive care
unit. Current, standard care for inpatient physical rehabilitation post lung transplant
involves a once daily session of physiotherapy for the duration of the patient's initial
inpatient stay, and consists of early mobility, aerobic exercise, upper and lower limb
strengthening and flexibility or core muscle re-training.
This trial aims to assess the feasibility and safety of twice daily physical rehabilitation
sessions during the post-operative period following lung transplantation. The content of the
additional physical rehabilitation session will not differ from, but will complement current
standard care, and will be delivered by a trained research assistant or physiotherapist. To
the investigator's knowledge, there is no current evidence to support the dosage and
intensity of inpatient physical rehabilitation following lung transplantation, and it is
unsatisfactory to use evidence from other patient groups to guide practice in this area.
To assess the feasibility of an intensive, inpatient physical rehabilitation program post
lung transplantation, the investigators will collect the following data: Number of patients
eligible for study inclusion; number of patients consented; number of additional, intensive
physical rehabilitation sessions completed; reasons for non-completion of sessions; and
attrition, or patient withdrawal rate. In order to assess the safety of the program, the
investigators will also assess for evidence of early, acute rejection of the transplanted
lungs based on the routine collection of tissue samples, and adverse events. Adverse events
will be defined as any event likely caused by acute physical rehabilitation, including
musculoskeletal injury, patient fall and surgical wound breakdown.
These assessments will be complemented by a number of physical and psychological outcome
measures and patient statistics, including tests of physical capacity, participation and
strength, quality of life, requirements for additional physical rehabilitation and/or
hospital readmissions within 10 weeks of study commencement, discharge destination and
patient length of stay data. Assessments will be completed within 3 days of first time to
mobilize, after three weeks and finally after 10 weeks post-transplant.
The investigators hypothesise that an intensive, physical rehabilitation program will be safe
and feasible to implement in the post-operative phase post lung transplantation, and that
participants in the intensive rehabilitation group will be more active at 10 days, and at 10
weeks than those receiving standard, post lung transplant physical rehabilitation.
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