title: Patterns and predictors of physical functional disability at 5 to 10 years after heart transplantation.
abstract: BACKGROUND
  Researchers have not examined relationships between perception of physical functional disability and demographic, clinical, and psychological variables at 5 to 10 years after heart transplantation. Therefore, the purposes of this study were to describe physical functional disability over time and identify predictors of physical functional disability from 5 to 10 years after heart transplantation.
  
  
  METHODS
  The study enrolled 555 patients who were between 5 and 10 years post-heart transplant (age, 54 +/- 9 years; 78% male, 88% white, 79% married). Patients completed 6 instruments that measure physical functional disability and factors that may impact physical functional disability. Statistical analyses included calculation of frequencies, means +/- standard deviation (plotted over time), Pearson correlation coefficients, and multiple regression coupled with repeated measures.
  
  
  RESULTS
  Between 5 and 10 years after heart transplantation, physical functional disability was low, and 34% to 45% of patients reported having no functional disability. More physical functional disability was associated with having more symptoms, having depression/mood/negative affect and lower use of negative coping strategies, having more comorbidities and more specific comorbidities (e.g., more orthopedic problems and diabetes); higher New York Heart Association functional class; having more acute rejection, infection, or cardiac allograft vasculopathy; being female, older, less educated, and unemployed; higher body mass index; and more hospital readmissions (explaining 46% of variance [F = 84.75, p < 0.0001]).
  
  
  CONCLUSIONS
  Demographic, clinical, and psychological factors were significantly related to physical functional disability. Knowledge of these factors provides the basis for development of therapeutic plans of care.
authors.affiliation: Northwestern Memorial Hospital, Chicago, Illinois, USA. kgrady@nmh.org
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Grady
authors.forename: David C
authors.initials: DC
authors.lastname: Naftel
authors.forename: James B
authors.initials: JB
authors.lastname: Young
authors.forename: Dave
authors.initials: D
authors.lastname: Pelegrin
authors.forename: Jennifer
authors.initials: J
authors.lastname: Czerr
authors.forename: Robert
authors.initials: R
authors.lastname: Higgins
authors.forename: Alain
authors.initials: A
authors.lastname: Heroux
authors.forename: Bruce
authors.initials: B
authors.lastname: Rybarczyk
authors.forename: Mary
authors.initials: M
authors.lastname: McLeod
authors.forename: Jon
authors.initials: J
authors.lastname: Kobashigawa
authors.forename: Julie
authors.initials: J
authors.lastname: Chait
authors.forename: Connie
authors.initials: C
authors.lastname: White-Williams
authors.forename: Susan
authors.initials: S
authors.lastname: Myers
authors.forename: James K
authors.initials: JK
authors.lastname: Kirklin
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D016027:Heart Transplantation / Q000009:adverse effects / Q000502:physiology* / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009068:Movement / Q000502:physiology; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000523:psychology; D012737:Sex Factors