Figures
- FIGURE 1
Flowchart of study methodology. PR: pulmonary rehabilitation.
- FIGURE 2
The effects of pulmonary rehabilitation on cognitive function in lung transplantation (LTx) recipients: a) total population (n=24), b) single LTx recipients (n=8 (33%)), c) bilateral LTx recipients (n=16 (66%)), d) male LTx recipients (n=14 (58%)) and e) female LTx recipients (n=10 (42%)). The dashed line indicates the mean effect size. *: p<0.05; **: p<0.001; ns: nonsignificant.
Tables
- TABLE 1
Demographics and clinical characteristics of the lung transplantation (LTx) recipients
Subjects 24 Female 10 (42) Age years 58.2±6.3 BMI kg·m−2 22.0±3.5 FEV1 % pred 75.4±22.0 FEV1/VC % pred 75.0±14.1 DLCO % pred 53.5±16.4 RV/TLC % pred 55.6±12.1 CRQ domain score Dyspnoea 4.7±2.1 Fatigue 4.9±1.5 Emotion 5.5±1.4 Mastery 5.8±1.4 HADS domain score Anxiety 4.4±4.2 Depression 3.8±3.5 Education years 8.0±2.6 IQ score 110.0±12.4 Single or bilateral LTx Single 8 (33) Bilateral 16 (67) α1-antitrypsin deficiency 8 (33) Data are presented as n, n (%) or mean±sd. BMI: body mass index; FEV1: forced expiratory volume in 1 s; VC: vital capacity; DLCO: diffusing capacity of the lung for carbon monoxide; RV: residual volume; TLC: total lung capacity; CRQ: Chronic Respiratory Disease Questionnaire; HADS: Hospital Anxiety and Depression Scale; IQ: Intelligence Quotient.
- TABLE 2
Lung function and exercise responses before and after the pulmonary rehabilitation (PR) programme in the 24 lung transplantation recipients
Pre-PR Post-PR Mean difference ES p-value FEV1 % pred 75.4±22.0 76.6±22.7 1.2±5.2 0.06 ns DLCO % pred 53.5±16.4 57.8±17.5 4.3±4.6 0.27 0.012 RV/TLC % pred 55.6±12.1 53.3±11.9 −2.3±3.2 0.20 0.017 Exercise data 6MWD m 346±127 432±113 86±77 0.73 <0.001 6MWD % pred 51.0±17.7 64.0±14.7 13.0±10.6 0.81 <0.001 SpO2 baseline % 96.5±1.4 97.0±1.4 0.5±1.5 0.36 ns SpO2 end-exercise % 92.6±6.3 93.9±3.9 1.3±5.1 0.08 ns ΔSpO2 percentage points −3.9±5.7 −3.1±3.3 0.8±4.8 0.17 ns HR baseline beats·min−1 87±13 87±12 0±12 0.01 ns HR end-exercise beats·min−1 108±18 116±17 8±10 0.47 0.002 ΔHR beats·min−1 21±19 29±14 8±15 0.49 0.029 DSP m% 326±124 406±109 80±63.9 0.70 <0.001 Unintended stop point m 340±130 424±115 84±75.6 0.70 <0.001 Data are presented as mean±sd, unless otherwise stated. ES: effect size; FEV1: forced expiratory volume in 1 s; DLCO: diffusing capacity of the lung for carbon monoxide; RV: residual volume; TLC: total lung capacity; 6MWD: 6-min walk distance; SpO2: arterial oxygen saturation measured by pulse oximetry; HR: heart rate; DSP: distance–saturation product. Level of significance was set at p≤0.05; ns: nonsignificant.
- TABLE 3
Cognitive function assessment before and after the pulmonary rehabilitation (PR) programme in the 24 lung transplantation recipients
Domain-specific evaluation Pre-PR Post-PR Mean difference ES p-value Memory ability WMS Logical Memory I score 11.0±2.7 12.9±2.4 1.9±2.7 0.76 0.004 WMS Logical Memory II score 9.7±3.0 11.9±3.8 2.2±2.9 0.66 0.003 CVLT Free recall: list 1 score 30.4±28.2 51.7±34.7 21.3±28.5 0.69 0.003 CVLT Free recall: list 2 score 33.3±31.1 47.8±34.1 14.5±26.0 0.45 0.022 CVLT Recall with help: list 1 score 38.7±26.6 50.9±33.6 12.2±31.6 0.41 ns CVLT Recall with help: list 2 score 38.5±28.7 50.7±30.9 12.2±23.9 0.42 0.034 CVLT Repeating errors score 68.6±21.8 70.9±27.5 2.3±26.4 0.09 ns Composite score 32.7±29.2 42.1±33.6 9.3±23.6 0.31 0.001 Learning skills CVLT Learning ability % 33.4±31.8 57.1±33.9 23.7±28.2 0.74 0.020 CVLT Passage 1 % 32.1±23.4 61.0±34.2 28.9±34.9 1.00 0.001 CVLT Passage 5 % 20.8±25.4 40.3±34.6 19.5±24.2 0.66 0.001 CVLT List B % 23.0±28.4 25.6±22.0 2.6±28.2 0.10 ns Composite score 27.5±27.5 46.4±34.2 18.9±30.4 0.62 0.001 Attention and flexibility TAP Speed/accuracy % 56.2±31.5 56.5±32.9 0.3±27.6 0.01 ns TAP Shared attention ability % 50.4±28.3 45.8±28.9 −4.6±33.0 0.16 ns Composite score 54.1±29.8 51.3±31.1 −2.8±30.1 0.09 ns Visuospatial and processing speed TMT-A score 42.8±14.9 38.3±20.1 −4.5±27.9 0.26 ns TMT-B score 99.0±52.2 84.9±35.2 −14.1±36.9 0.32 ns Composite score 70.9±47.4 61.6±36.9 −9.3±32.7 0.22 ns Visuospatial and praxis ability CDT Clock test score 13.1±1.2 13.1±1.3 0.0±0.7 0.01 ns Psychomotor speed Stroop colour-word read points 48.5±7.5 51.3±7.7 2.8±4.9 0.38 0.015 Stroop colour recognition points 54.4±8.1 57.4±9.3 3.0±6.0 0.35 0.027 Stroop interference points 55.0±9.7 55.3±9.3 0.3±7.7 0.03 ns Composite score 52.6±8.8 54.6±9.0 2.0±6.3 0.23 0.012 Behavioural activation BADS version 1 score 6.8±1.6 6.1±1.6 −0.7±2.6 0.42 ns BADS version 2 score 7.6±0.7 7.6±0.7 −0.0±0.9 0.01 ns Composite score 7.1±1.3 6.8±1.4 −0.3±1.9 0.23 ns Data are presented as mean±sd, unless otherwise stated. ES: effect size; WMS: Wechsler Memory Scales IV; CVLT: California Verbal Learning Test; TAP: Test of Attentional Performance; TMT: Trail Making Test; CDT: Clock-Drawing Test; BADS: Behavioural Assessment of the Dysexecutive Syndrome. Positive values (better scores) determine improvement for memory ability, learning skills, psychomotor speed (points) and visuospatial/praxis ability, while negative values (faster responses) determine improvement (expressed as positive ES) for behavioural activation, visuospatial and processing speed, and attention/flexibility. Level of significance was set at p≤0.05; ns: nonsignificant.
- TABLE 4
Mean effect sizes (ESs) for the relationship between the magnitude of improvement in cognitive function and the time interval between lung transplantation (LTx) and the pulmonary rehabilitation (PR) programme
Time to PR months LTx recipients n t ES p-value Mean±sd 95% CI 1–2 6 3.66 0.15±0.11 0.05–0.25 0.011 2–12 5 2.67 0.28±0.28 0.02–0.54 0.037 >12 13 3.12 0.34±0.28 0.07–0.60 0.020 Mean ES was defined as the mean value of all cognitive domain ESs. A significant mean ES indicates a directional trend of global improvement in cognitive function.
Supplementary Material
Please note: supplementary material is not edited by the Editorial Office, and is uploaded as it has been supplied by the author.
Supplementary material 00060-2019.SUPPLEMENT
Figure S1 00060-2019.figureS1
Figure S2 00060-2019.figureS2
