Correlates and Outcomes of Low Physical Activity Posttransplant: A Systematic Review and Meta-Analysis.

Abstract BACKGROUND: Little is known about associations between low physical activity (PA) and its correlates and outcomes in solid organ transplant recipients. This systematic review with meta-analysis examined correlates and outcomes associated with low PA (i.e. not meeting individual study's definition of being physically active) following solid organ transplantation. METHODS: We searched PubMed, CINAHL, PsycINFO and EMBASE from inception to February 2016 to identify peer-reviewed data-based articles. Articles published in English, German, Spanish, French, Italian, Portuguese, or Dutch that examined correlates or outcomes associated with low PA in adult single, solid organ transplant recipients were included. Studies' quality was assessed using a 14-item checklist. Pooled odds ratios and 95% confidence intervals were computed for correlates and outcomes examined in ≥ 5 studies. RESULTS: Of 7,401 publications screened, 34 studies met inclusion criteria and were included in the overall synthesis with 15 included in the meta-analysis. Most focused on renal transplantation (n=18, 53%) and used cross-sectional designs (n=26, 77%). Of 30 correlates examined, [condition-related (n=11), social/economic-related (n=9), patient-related (n=4), healthcare system-related (n=3), and treatment-related (n=3)], only four were examined ≥5 times and included in meta-analyses. None were significantly related to low PA. Of 19 outcomes assessed, only physical health-related quality of life was examined ≥ 5 times. Low PA was significantly associated with low physical health-related quality of life (OR=0.172, 95% CI=0.08, 0.37). CONCLUSIONS: We found few studies examining most correlates and outcomes related to low PA despite growing evidence that improving PA might be an effective intervention in improving post-transplant outcomes