title: Physical activity in solid organ transplant recipients: organizational aspects and preliminary results of the Italian project.
abstract: Most of the difficulties when trying to realize the proposal to prescribe physical activity for transplantation patients come from patient attitudes and cultural beliefs that ignore the benefits of exercise, but there also are organizational aspects arising from the difficulties that these patients face in accessing supervised exercise facilities. To address these difficulties, the Italian study project "Transplant … and Now Sport" was developed based on a model of cooperation among transplantation specialists, sports physicians, and exercise specialists organized as a team combining their specific skills to effectively actuate the physical exercise programs. This preliminary report is based on 26 patients (16 male, 10 female; 47.8±10.0 years old; 21 kidney and 5 liver transplantations; time from transplantation 2.3±1.4 years) who performed prescribed and supervised exercises consisting of 3 sessions per week of aerobic and strengthening exercises for 1 year. Preliminary results show a significant decrease in body mass index (t=1.966; P<.05) and a significant increase in peak aerobic power (t=4.535; P<.01) and maximum workload (t=4.665; P<.01) on the incremental cycling test. Also maximum strength of knee extensors (t=2.933; P<.05) and elbow flexors (t=2.450; P<.05) and countermovement jump performance (t=2.303; P<.05) significantly increased. Creatinine and proteinuria tended to decrease, but the differences were not significant. In health-related quality of life assessed by the SF-36 questionnaire, the Bodily Pain, General Health, Vitality, Social Functioning, and Role Emotional scale scores showed a significant improvement (P<.05). Preliminary results of the study protocol "Transplant…and Now Sport" show the positive effects of the model based on cooperation among transplantation centers, sports medicine centers, and gyms in the administration of a supervised exercise prescription. These data should be considered a contribution to developing and promoting further detailed exercise protocols and to fostering improved posttransplantation health and survival, helping to ensure that physical activity becomes a safe routine medical treatment plan of patient management.
authors.affiliation: Educational and Research Department, Isokinetic Medical Group, Bologna, Italy.
authors.forename: G S
authors.initials: GS
authors.lastname: Roi
authors.affiliation: Section of Nephrology, Department of Internal Medicine, Aging and Renal Disease, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Stefoni
authors.affiliation: Operative Unit of Nephrology and Dialysis, Morgagni Pierantoni Hospital, Forlì, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mosconi
authors.affiliation: UOC of Sports medicine, Cardiovascular Department, Noale, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Brugin
authors.affiliation: Multivisceral Transplant Unit, Gastroenterology, Department of Surgery, Oncology and Gastroenterology, Padua, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Burra
authors.affiliation: Sports Medicine Unit DIMED, Department of Medicine, University of Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ermolao
authors.affiliation: Division of Nephrology Dialysis and Renal Transplantation, Modena, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Granito
authors.affiliation: Emilia-Romagna Public Health Service, Bologna, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Macini
authors.affiliation: Nephrology and Dialysis Unit, Treviso, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Mastrosimone
authors.affiliation: First Surgical Clinic, Kidney Transplantation Centre, Verona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Nacchia
authors.affiliation: UOC of Sports medicine, ULSS Company 9, Treviso, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pegoraro
authors.affiliation: Department of Surgery, Oncology and Gastroenterology, Kidney and Pancreas Transplantation Unit, University of Padua, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Rigotti
authors.affiliation: UOC of Sports medicine, Regional Hospital of Ravenna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sella
authors.affiliation: UOC of Sports medicine, Regional Hospital of Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Sgarzi
authors.affiliation: Department of Digestive Diseases and Internal Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Italy.
authors.forename: M R
authors.initials: MR
authors.lastname: Tamè
authors.affiliation: No Profit Foundation for the Advancement of Organ and Tissue Transplantation (FITOT), Padua, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Totti
authors.affiliation: Italian National Transplant Centre, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Trerotola
authors.affiliation: UOC of Sports medicine, Regional Hospital of Modena, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Tripi
authors.affiliation: Italian National Transplant Centre, Rome, Italy. Electronic address: daniela.storani@iss.it.
authors.forename: A
authors.initials: A
authors.lastname: Nanni Costa
mesh_terms: D015992:Body Mass Index; D015444:Exercise; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010348:Patient Care Team; D011788:Quality of Life; D066027:Transplant Recipients