Billany RE; Division of Cardiovascular Sciences,, Leicester, UK.
Vadaszy N; Burns S; Chowdhury R; Ford EC; Mubaarak Z;
Sohansoha GK; Yeo JL; Dattani A; Cowley AC; Gulsin GS; Bishop NC; Smith
AC; McCann GP; Graham-Brown MP

Clinical Rehabilitation. 40(5):587-602, 2026 May.

Objectives (1) Explore the effects of a 12-week home-based rehabilitation
programme on cardiorespiratory fitness in kidney transplant recipients;
(2) Compare cardiorespiratory fitness parameters in kidney transplant
recipients and age-sex matched healthy volunteers to aid the justification
for routine rehabilitation programmes.
Design  Pilot randomised controlled
trial with nested case-control. Setting Home-based rehabilitation;
hospital-based outcome assessments. Participants Pilot randomised
controlled trial: 50 stable kidney transplant recipients (>1 year
post-transplant) (randomised 1:1; n = 25 control and n = 25 intervention).
Nested case-control: 30 kidney transplant recipients and 30 healthy
volunteers. InterventionA 12-week home-based aerobic and resistance
rehabilitation programme or guideline-directed care control.Main
measuresCardiorespiratory fitness measured by cardiopulmonary exercise
testing.
Results Pilot randomised controlled trial: After adjusting for
baseline, follow-up values were significantly greater in intervention
compared to control for peak oxygen uptake (VO2peak) mL/kg/min, (+1.50, p
= .03) and maximum workload (+8 W, p = .04) but not VO2peak L/min or
variables at the gas exchange threshold. Higher frequency of aerobic
exercise sessions was associated with greater improvements in
cardiorespiratory fitness (R2 = .252, p = .040). Nested case-control:
VO2peak was reduced in kidney transplant recipients compared to healthy
volunteers (18.81 +/- 4.61 vs 24.06 +/- 5.72 mL/kg/min; p < .01), as was
VO2 at the gas exchange threshold (11.70 +/- 2.67 vs 14.47 +/- 3.39
mL/kg/min; p < .01).
Conclusions A 12-week home-based rehabilitation
programme induced a significant improvement in some cardiorespiratory
fitness variables and higher frequency of aerobic exercise associated with
greater improvements. Cardiorespiratory fitness is significantly impaired
in kidney transplant recipients compared to age-sex-matched healthy
volunteers. Together, these findings highlight the clinical importance of
promoting aerobic exercise and the integration of rehabilitation
programmes into routine care for this population.