Authors (including presenting author) :
Kwok CKC (1), Chan ACM (1), Chow KF (2), Yu DTW(1), Cheung CWL (1), Au ILY (1)
Affiliation :
(1) Physiotherapy Department, Queen Elizabeth Hospital
(2) Department of Medicine, Queen Elizabeth Hospital
Introduction :
Organ transplantation is the last resort of treatment for patients with end-stage organ failure. Common physical complications include decline in maximal oxygen consumption and anaerobic threshold. Physical activities improves cardiovascular fitness, quality of life and reduces anxiety and depression. World Transplant Games (WTG) is a bi-annual global sport event for recipients and donors of organ transplant, with the major objective of promoting sports among post-organ transplant patients. In previous games, cardiovascular accidents have occasionally been reported. By far there is no standardized screening tool available to ensure the safety of the participants of WTG. In Hong Kong since 2008, local physiotherapists and medical team developed an integrated submaximal exercise test (iSET) for WTG participants to assess their cardiovascular capacities for participants’ references in choosing their sport events. More than 150 subjects had been screened by iSET prior to WTG since then. No major incidents happened in Hong Kong team participants.
Objectives :
To evaluate the cardiovascular fitness for individuals after organ-transplant and the incident rate on sports participation after screening by iSET.
Methodology :
Transplant recipients who participated in the WTG 2019 and underwent iSET was studied. Before the exercise test, resting blood pressure, pulse rate and 12-lead electrocardiogram were measured. Modified Bruce protocol was adopted in the iSET. During testing, heart rate, blood oxygen saturation and rate of perceived exertion were closely monitored by a team of experienced physiotherapists. The results of the iSET provided an indicator on the safety limit of suggested exercise level. Participants with exercise capacity in metabolic equivalent (MET) exceeding the requirement for their target sports would proceed to join the events as planned; while those who failed would be referred for stress ECG test or advised to join sports with lower exercise intensity.
Result & Outcome :
Twenty-six participants (mean age: 54.1±15.4 years old; 10 males, 16 females) were evaluated. 19 of the 26 subjects passed iSET, while 7 subjects (26.9%) failed to attain required exercise capacity for their target sport events. Among the 7 subjects who failed, 2 subjects were suggested to switch to sport events with lower exercise intensity due to abnormal ECG results while another other 5 were referred for standard stress test. Within these 5 subjects, 3 subjects showed normal exercise ECG, and were either given advice or switched to sport events with lower exercise intensity. Zero incidents happened in the entire WTG 2019 event due to cardiovascular unfit.
iSET is easy to conduct and low-cost. It can be a potentially used as a routine screening tools for ensuring safe participation in sports for individuals after post-transplant.
