Pulmonary Rehabilitation Training for Liver Transplant Patients Using Wearable Smartwatches: A Randomized Controlled Trial

Background: Liver transplant patients often face significant pulmonary rehabilitation challenges post-surgery. Although postoperative rehabilitation has been studied, specific pulmonary rehabilitation programs remain underexplored. This study aims to evaluate the benefits of a 12-week home-based pulmonary rehabilitation program on respiratory function recovery in liver transplant patients. Methods: This randomized controlled trial was conducted at a medical center in southern Taiwan from January 1, 2022, to December 31, 2023. Seventy-two liver transplant patients were enrolled and randomly assigned to the training group (n = 38) or the control group (n = 34). The training group underwent a 12-week pulmonary rehabilitation program post-discharge, including inspiratory muscle training and exercise training. The control group received only traditional training (Triflo). Demographic characteristics, surgical features, inspiratory muscle strength, and pulmonary function recovery were collected. Data analysis was performed using SPSS 20.0, employing Chi-square tests, Student’s t-tests, and two-way ANOVA with repeated measures. Wearable smartwatches monitored hemodynamics and blood oxygen saturation. Results: The study found that patients in the training group showed significant improvement compared to the control group in maximal inspiratory pressure (59.53 ± 9.72 cm H2O vs. 51.89 ± 8.53 cm H2O, P < .001), maximal expiratory pressure (60.88 ± 10.27 cm H2O vs. 55.21 ± 7.76 cm H2O, P < .003), vital capacity (2.55 ± 0.38 L vs. 1.86 ± 0.32 L, P < .001), dyspnea levels (0.14 ± 0.33 vs. 0.43 ± 0.50, P < .001), and blood oxygen saturation (98.42 ± 1.14% vs. 96.79 ± 1.31%, P < .001). Conclusions: This study demonstrates that a 12-week home-based pulmonary rehabilitation program enhances respiratory muscle strength, increases vital capacity, reduces dyspnea, and improves hemodynamics and blood oxygen saturation in liver transplant patients. Additionally, the use of wearable smartwatches as a monitoring tool for home-based pulmonary rehabilitation is practical and effective. These findings provide important strategies for the postoperative care of liver transplant patients.