Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 24, 2016; 6(4): 774-789
Published online Dec 24, 2016. doi: 10.5500/wjt.v6.i4.774
Outcomes in randomized controlled trials of exercise interventions in solid organ transplant
Tania Janaudis-Ferreira, Sunita Mathur, Stacey Konidis, Catherine M Tansey, Cecile Beaurepaire
Tania Janaudis-Ferreira, Sunita Mathur, Canadian National Transplant Research Program, Edmonton, AB T6G 2E1, Canada
Tania Janaudis-Ferreira, Catherine M Tansey, Cecile Beaurepaire, School of Physical and Occupational Therapy, McGill University, Montreal, QC H3G1Y5, Canada
Sunita Mathur, Stacey Konidis, Department of Physical Therapy, University of Toronto, ON M5G 1V7, Canada
Author contributions: Janaudis-Ferreira T designed the research question and protocol, screened titles and abstracts and drafted the manuscript; Mathur S assisted with the interpretation of the findings and provided critical feedback on the manuscript; Konidis S screened titles, abstracts and full-texts, assisted with extracting the data and drafting the manuscript; Tansey CM assisted with data extraction and tabulation and manuscript writing; Beaurepaire C assisted with data extraction and tabulation; all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Data sharing statement: The original tables are available from the corresponding author at tania.janaudis-ferreira@mcgill.ca.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tania Janaudis-Ferreira, PhD, School of Physical and Occupational Therapy, McGill University, 3630 Promenade Sir-William-Osler, Montreal, QC H3G1Y5, Canada. tania.janaudis-ferreira@mcgill.ca
Telephone: +1-514-3985326 Fax: +1-514-3988193
Received: June 29, 2016
Peer-review started: July 1, 2016
First decision: September 5, 2016
Revised: September 29, 2016
Accepted: October 22, 2016
Article in press: October 24, 2016
Published online: December 24, 2016
Abstract
AIM

To identify the outcome measures that have been used in randomized controlled trials (RCTs) of exercise training in solid organ transplant (SOT) recipients and to link these outcomes to the International Classification of Functioning, Disability and Health (ICF) framework.

METHODS

Electronic literature searches of MEDLINE, EMBASE, CINAHL, Cochrane, Scopus, and Web of Science were performed. We sought RCTs that investigated the effect of exercise training in SOT recipients. Reference lists of all eligible publications were searched for other appropriate studies not identified by the electronic search. A complete list of outcome measures used in the RCTs was generated and each of these was linked to an ICF category.

RESULTS

Four hundred and thirteen articles were retrieved, of which 35 met our inclusion criteria. The studies included were designed to compare the effects of exercise training programs to usual care or to another exercise training program and reported on recipients of heart (n = 21), kidney (n = 9), lung (n = 3) or liver (n = 2) transplant. Of the 126 outcome measures identified, 62 were used as primary outcome measures. The most commonly occurring primary outcomes were aerobic capacity using the peak VO2 (n = 13), quality of life using the short-form-36 (n = 8), and muscle strength (n = 7). These outcome measures were linked to 113 ICF categories and the majority of outcomes fall into the body function domain (n = 93).

CONCLUSION

There is little standardization in outcome measures used in RCTs of exercise interventions in SOT recipients. The ICF framework can be used to select a core set of outcomes that cross all domains of ICF and that would be appropriate to all SOT recipients.

Keywords: Solid organ transplantation, Systematic review, Rehabilitation, Exercise, Outcome measures, International Classification of Functioning, Disability and Health

Core tip: Over 30 randomized controlled trials (RCTs) have been conducted to examine the effectiveness of exercise training on outcomes in solid organ transplant recipients. However, the synthesis of findings across studies has been limited by the lack of similar outcomes. We identified 126 unique outcomes used in RCTs of exercise training and categorized them according to the International Classification of Functioning, Disability and Health framework. Most commonly, outcomes fell into the domains of body structure and body function, whereas there were a limited number of outcomes examining activities and participation. This review highlights the need for a core set of outcomes for RCTs in exercise training for this population.