Copyright ©The Author(s) 2016.
World J Transplant. Sep 24, 2016; 6(3): 517-531
Published online Sep 24, 2016. doi: 10.5500/wjt.v6.i3.517
Table 4 Guidelines for early post-transplant exercise prescription in stable outpatients
Frequency3-5 d/wk2-3 d/wk3-5 d/wk
Intensity50%-80% HR reserve or < 85% age-predicted HRmax[4,23] Leg fatigue > dyspnea: Moderate to hard (3-4 on Borg scale) SpO2 > 88% Continuous training: 75%-100% 6MWT speed for walking[24,25] 50%-80% peak workload for cycling[24,59,128]60%-80% 1RM[24,26] 10-RM No upper extremity lifting/pulling/pushing > 10 lbs. first 3 month Extra restrictions if sternal instabilityHold stretches to point of tightness/slight discomfort
TypeWalking (treadmill, corridor) Cycling (leg); avoid arm ergometry in first 3 month to allow for incision healingSee pre-transplant Avoid abdominal muscle exercises for first 3 monthMajor muscle groups of upper and lower body Thoracic cage and chest wall mobility Postural re-education
Time/ Training VolumeContinuous: 20-30 min1-3 sets × 8-15 repsHold up to 10-30 s each, repeat 2-4 times
ProgressionProgress time to 30 min, then progress speed on treadmill; increase incline after approximately 6 wk post-transplant (if tolerated) Increase Watts on cycle Walk: Run program for some high level patients (at least 6 wk post-transplant) 30-60 s running bouts interspersed with walking for 20-30 minStart with sit-stands and when able to perform without arm support progress to squats with hand weights Weekly increase weights based on tolerance; (approximately 0.5 kg or 1 lb. per week, as tolerated) within lifting guidelines (e.g., < 10 lbs. for upper extremities for first 3 month) Body weight exercises: Can add hand or ankle weights (e.g., squats and stair climbing)Hold stretches to point of tightness/slight discomfort Extra restrictions if sternal instability (e.g., avoid chest expansion stretches)