Implementation of Standardized Outcome Measures in Acute Inpatient Rehabilitation After Lung Transplantation: A Case Report

Vollständiger Abstract

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Background and Purpose: Lung transplantation presents unique rehabilitation challenges, particularly in the acute postoperative phase where formal physical therapy guidelines are limited. Evidence supporting their use in this setting, however, remains limited. The purpose of this case report was to describe the implementation of a standardized battery of outcome measures and the physical therapy management of a medically complex patient in the acute phase after bilateral lung transplantation (LT). Case Description: A 66-year-old man with end-stage COPD underwent bilateral LT with left diaphragm plication. Postoperatively, the patient presented with significant deconditioning, impaired functional endurance, and required assistance of 2 individuals for all mobility. Intervention: Physical therapy was provided once daily, 6 days per week, progressing from early mobilization and upright tolerance to pregait activities, progressive ambulation, lower extremity strengthening, and endurance training. Outcomes: The AM-PAC 6-Clicks score improved from 11 to 23, the 6-Minute Walk Test from 23.77 to 246.58 m, the Short Physical Performance Battery from 3/12 to 10/12, and the Five Times Sit-to-Stand from 90 to 16.62 seconds. The patient was discharged home on hospital day 21 at a supervision level without an assistive device and on room air. Discussion: This case demonstrates that implementing a standardized outcome measure battery during acute inpatient LT rehabilitation is both feasible and clinically valuable. These tools facilitated data-driven decision-making, supported interdisciplinary communication, and informed discharge planning, establishing a foundational protocol for future LT rehabilitation.