Each training session was approximately 90 minutes and comprised cycle

ergometry, walking, stair climbing, and leg press resistance exercises. Training was prescribed at moderate to high intensity and progressed according to symptoms. Outcome measures: The primary outcome was time spent walking each day. Secondary outcomes included Fluorouracil in vivo the six-minute walk distance (6MWD), peripheral muscle force, HRQL, and FEV1. Results: Data were available on 18 and 16 patients in the intervention and control groups, respectively. On completion of the intervention, between-group differences in favour of the intervention group were demonstrated in the average time spent walking each day (difference in means 14 min, 95% CI 4 to 24), 6MWD (differences in means 9% predicted, 95% CI 3 to 15) and quadriceps force (difference in means 17% predicted, 95% CI 9 to 24), but not HRQL or FEV1. These between-group differences were maintained 12 months following discharge from hospital. At the 12 month assessment, between-group differences in favour of the intervention group were also demonstrated in two

components of HRQL related to physical function. Conclusion: In patients following Veliparib mw lung transplant, exercise training conferred immediate and sustained gains in physical activity during daily life and exercise capacity. Gains in HRQL also appear to be evident, but took longer to be realised. Although functional capacity improves following lung transplantation, TCL persistent limitations primarily attributed to skeletal muscle dysfunction have been observed (Mathur et al 2004). Several studies have examined the effects

of exercise training following lung transplantation, including two randomised controlled trials targeting lumbar bonemineral density (Wickerson et al 2010). This study by Langer et al (2012) is the first randomised trial of exercise training on endurance capacity, quadriceps force, and physical activity. This research design allows the effects of the exercise training to be separated from spontaneous functional recovery. In interpreting the study findings, it is important to recognize that more than 70% of lung transplant recipients at this single centre were excluded. The study participants are not fully representative of the lung transplant population as they were between 40 and 65 years of age, experienced an uncomplicated post-operative course, and 85% had a pre-transplant diagnosis of COPD. Although this study was not powered to detect differences in cardiovascular morbidity, the finding of lower average 24 hour ambulatory blood pressure and lower incidence of treatment of diabetes in the intervention group one year after hospital discharge, and more hypertensive medication prescribed in the control group is clinically relevant. It extends the benefits of exercise training beyond functional measures to broader health outcomes and highlights a potential preventive role of exercise in a population that experiences significant longterm morbidity.