Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol

Introduction Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training...

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Autores principales:	Juliana Beust de Lima, Douglas dos Santos Soares, Filipe Ferrari, Nelson Carvas Junior, Gabriel Carvalho, Santiago Alonso Tobar Leitão, Lívia Adams Goldraich, Nadine Clausell, Ricardo Stein
Formato:	article
Lenguaje:	EN
Publicado:	BMJ Publishing Group 2020
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/d22d842de2304f0e957882076855e4d2
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spelling	oai:doaj.org-article:d22d842de2304f0e957882076855e4d22021-11-11T17:30:08ZExercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol10.1136/bmjopen-2020-0449752044-6055https://doaj.org/article/d22d842de2304f0e957882076855e4d22020-12-01T00:00:00Zhttps://bmjopen.bmj.com/content/10/12/e044975.fullhttps://doaj.org/toc/2044-6055Introduction Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients.Methods and analysis We will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository.Ethics and dissemination Given the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal.PROSPERO registration number CRD42020191192.Juliana Beust de LimaDouglas dos Santos SoaresFilipe FerrariNelson Carvas JuniorGabriel CarvalhoSantiago Alonso Tobar LeitãoLívia Adams GoldraichNadine ClausellRicardo SteinBMJ Publishing GrouparticleMedicineRENBMJ Open, Vol 10, Iss 12 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Juliana Beust de Lima Douglas dos Santos Soares Filipe Ferrari Nelson Carvas Junior Gabriel Carvalho Santiago Alonso Tobar Leitão Lívia Adams Goldraich Nadine Clausell Ricardo Stein Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
description	Introduction Heart transplantation is the gold standard treatment for selected patients with end-stage heart failure. Although this procedure can improve quality and prolong life expectancy, several of these patients persist with decreased exercise tolerance. Evidence suggests that exercise training can bring multifactorial benefits to heart transplant (HTx) recipients. However, it is unclear that exercise modality should be preferred. Therefore, the aim of this systematic review and network meta-analysis is to compare the efficacy and safety of different training modalities in HTx recipients.Methods and analysis We will perform a comprehensive literature search in PubMed/MEDLINE, Embase, The Cochrane Library, CINAHL, Scopus, SportDISCUS, Web of Science Core Collection and PEDro from inception until November 2020. Two registries (ClinicalTrials.gov and REBEC) will also be searched for potential results in unpublished studies. There will be no restriction on language, date of publication, publication status or sample size. We will include randomised controlled trials enrolling adult HTx recipients with the presence of at least one exercise training group, which might be compared with another training modality and/or a non-exercise control group for a minimum of 4 weeks of intervention. The primary outcomes will be peak oxygen consumption and occurrence of adverse events. As secondary outcomes, the interaction between pulmonary ventilation, pulmonary perfusion and cardiac output, oxygen uptake efficiency slope, heart rate response, oxygen pulse, peak blood pressure and peak subjective perception of effort. In addition, we will evaluate the 6 min walking distance, health-related quality of life, endothelial function, muscle strength, body fat percentage and lean mass. Risk of bias will be assessed using the Cochrane RoB V.2.0 tool, and we plan to use the Confidence in Network Meta-Analysis tool to assess confidence in the results. All materials (raw data, processed data, statistical code and outputs) will be shared in a public repository.Ethics and dissemination Given the nature of this study, no ethical approval will be required. We believe that the findings of this study may show which is the most efficacious and safe physical training modality for HTx recipients. The completed systematic review and network meta-analysis will be submitted to a peer-reviewed journal.PROSPERO registration number CRD42020191192.
format	article
author	Juliana Beust de Lima Douglas dos Santos Soares Filipe Ferrari Nelson Carvas Junior Gabriel Carvalho Santiago Alonso Tobar Leitão Lívia Adams Goldraich Nadine Clausell Ricardo Stein
author_facet	Juliana Beust de Lima Douglas dos Santos Soares Filipe Ferrari Nelson Carvas Junior Gabriel Carvalho Santiago Alonso Tobar Leitão Lívia Adams Goldraich Nadine Clausell Ricardo Stein
author_sort	Juliana Beust de Lima
title	Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
title_short	Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
title_full	Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
title_fullStr	Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
title_full_unstemmed	Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
title_sort	exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol
publisher	BMJ Publishing Group
publishDate	2020
url	https://doaj.org/article/d22d842de2304f0e957882076855e4d2
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Exercise training modalities for heart transplant recipients: a systematic review and network meta-analysis protocol

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