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 andreduced quality of life. Telerehabilitation (TR) offers a viable alternativefor patients with limited access to center-based rehabilitation. This systematic review assessed TR's clinical efficacy in LTC and LTRpopulations. Methods: Eligible trials were identified by searching the PubMed,Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, andScopus databases. Continuous data were extracted for relevant outcomes andanalyzed 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 significantlyimproved 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 andLTR (PMD:-11.98 [-17.99--5.97], p < 0.0001, I² = 83%). Several telerehabilitation trialshave suggested potential benefits in improving exercise capacity, physicalfitness, and quality of life in LTC and LTR, both before and aftertransplantation. However, the overall quality of the evidence remains low.Further research is needed to evaluate the impact of telerehabilitation onclinical outcomes, and feasibility, and cost-effectiveness of theserehabilitation delivery model in this population. The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42022378573).