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Mobile health technology to improve emergent frailty after lung transplantation
Author(s) -
Diamond Joshua M.,
Courtwright Andrew M.,
Balar Priya,
Oyster Michelle,
Zaleski Derek,
Adler Joe,
Brown Melanie,
Hays Steven R.,
Sutter Nicole,
Garvey Chris,
Kukreja Jasleen,
Gao Ying,
Bruun Allan,
Smith Patrick J.,
Singer Jonathan P.
Publication year - 2021
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14236
Subject(s) - medicine , physical therapy , rehabilitation , mhealth , tolerability , randomized controlled trial , adverse effect , pulmonary rehabilitation , physical medicine and rehabilitation , psychological intervention , surgery , nursing
We evaluated the feasibility, safety, and efficacy of a mHealth‐supported physical rehabilitation intervention to treat frailty in a pilot study of 18 lung transplant recipients. Frail recipients were defined by a short physical performance battery (SPPB score ≤7). The primary intervention modality was Aidcube, a customizable rehabilitation mHealth platform. Our primary aims included tolerability, feasibility, and acceptability of use of the platform, and secondary outcomes were changes in SPPB and in scores of physical activity, and disability measured using the Duke Activity Status Index (DASI) and Lung Transplant‐Value Life Activities (LT‐VLA). Notably, no adverse events were reported. Subjects reported the app was easy to use, usability improved over time, and the app enhanced motivation to engage in rehabilitation. Comments highlighted the complexities of immediate post‐transplant rehabilitation, including functional decline, pain, tremor, and fatigue. At the end of the intervention, SPPB scores improved a median of 5 points from a baseline of 4. Physical activity and patient‐reported disability also improved. The DASI improved from 4.5 to 19.8 and LT‐VLA score improved from 2 to 0.59 at closeout. Overall, utilization of a mHealth rehabilitation platform was safe and well received. Remote rehabilitation was associated with improvements in frailty, physical activity and disability. Future studies should evaluate mHealth treatment modalities in larger‐scale randomized trials of lung transplant recipients.