Inspiratory muscle training in solid organ transplant candidates and recipients: A scoping review

Background Solid organ transplants (SOT) such as those of the lungs, heart, kidneys, pancreas, and liver are associated with physical impairments and functional limitations. Rehabilitation is a key component of care both pre- and post-surgery. Inspiratory muscle training (IMT) can be used to strengthen the respiratory muscles and may have significant effects on clinical outcomes and healthcare utilization in SOT candidates and recipients. Objectives This scoping review aims to determine how IMT is used in SOT candidates and recipients by: 1) identifying which populations have been considered for IMT, 2) describing the IMT protocols used, and 3) examining the impact of IMT on clinical outcomes and healthcare utilization. Methods A scoping review was conducted following the framework outlined by Arksey & O'Malley. A comprehensive search was performed in MEDLINE, EMBASE, and CINAHL. Articles were screened based on inclusion and exclusion criteria by two investigators. Data were extracted and reported to address the research objectives. Results Fourteen studies targeting heart, lung, liver, kidney, and heart-lung transplant candidates or recipients evaluated IMT using different intensity, duration, and devices. Most studies focused on heart and lung transplant. Outcomes such as inspiratory muscle pressure, dyspnea, exercise capacity, and quality of life were assessed. IMT demonstrated improvements in respiratory strength, symptoms, and physical function across organ groups. Conclusion IMT shows promise in improving clinical outcomes for SOT candidates and recipients. However, variability in protocols highlights the need for further research to define optimal strategies and assess long-term impacts on healthcare utilization.