VEXT : an 8-week virtual exercise and texting program for pediatric solid organ transplant patients

INTRODUCTION: Pediatric solid organ transplant (SOT) recipients report lower physical activity levels, exercise capacity, muscular strength, and quality of life than their healthy peers. Opportunities for structured recreational activity are limited for this population. Virtual exercise programs may reduce barriers to exercise, allow better access to specialized care, and cost less than traditional exercise rehabilitation programs. The aim of this study was to implement an 8-week virtual exercise program for pediatric SOT recipients. METHODS: A circuit-based training program with a primary focus on strength was designed by a clinical exercise physiologist (AD). All participants completed a treadmill exercise stress test prior to starting the exercise program. Self-report surveys were used to assess quality of life (Pediatric Quality of Life Inventory, PedsQL), fatigue (Pediatric Quality of Life Multidimensional Fatigue Scale, PedsQL-Fatigue), and physical activity (Physical Activity Questionnaire for Children and Adolescents, PAQ) at baseline and at completion of the program. The strength subtest of the Bruininks-Oseretsky Test of Motor Proficiency (2nd Edition) was administered virtually pre- and post-intervention. Exercise classes were conducted via Zoom, thrice weekly for 30 minutes. Weekly engagement with the study team was provided through a web-based text messaging platform (WelTel Inc., Vancouver, BC). Participants who could not attend a class were sent a recorded link of the class via email. RESULTS: Prior to the intervention, the median z-score for strength was -1.00 (-1.65 - -0.60). After the exercise intervention, strength scores improved to a z-score of -0.20 (-1.30 - 0.40); p=0.007. There were no changes in z-scores for the PAQ (-0.53 (-1.60 - -0.01) vs. -0.28 (-1.78 – 0.21) p=0.959, PedsQL -0.83 (-1.79 - -0.02) vs. -0.81 (-1.80 - -0.20); p=0.441, or PedsQL Fatigue [-0.75 (-1.90 - -0.08) vs. -0.74 (-1.49 - -0.16), p=0.314]. CONCLUSION: Results showed that the delivery of this program was successful amongst participants. Increases in strength were seen following the 8-week exercise program with no changes in total quality of life, daily physical activity levels, and fatigue. These results suggest that a virtual exercise program may be used in future studies involving pediatric SOT patients to promote exercise.Education, Faculty ofKinesiology, School ofGraduat