Telerehabilitation in lung transplant recipients and candidates - an exploratory systematic review and meta-analysis

Lung transplant candidates (LTC) and recipients (LTR) frequently suffer from impaired exercise capacity and reduced quality of life. Telerehabilitation (TR) offers a viable alternative for patients with limited access to center-based rehabilitation.

This systematic review assessed TR's clinical efficacy in LTC and LTR populations. Methods: Eligible trials were identified by searching the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus databases. Continuous data were extracted for relevant outcomes and analyzed using the RevMan software as the pooled mean difference (PMD) and 95%CI in a fixed-effect meta-analysis model.

Seven studies (n = 230; mean age = 54.2 years) were included. TR significantly improved 6-minute walk distance in LTR (PMD:65.78 m [5.15-126.42], p = 0.03, I² = 0%).The Duke Activity Status Index scores showed significant improvement in LTC and LTR (PMD:-11.98 [-17.99-5.97], p < 0.0001, I² = 83%).

Several telerehabilitation trials have suggested potential benefits in improving exercise capacity, physical fitness, and quality of life in LTC and LTR, both before and after transplantation. However, the overall quality of the evidence remains low. Further research is needed to evaluate the impact of telerehabilitation on clinical outcomes, and feasibility, and cost-effectiveness of these rehabilitation delivery model in this population.

The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42022378573).