# Lung Transplant Go (LTGO): Improving Self-Management of Exercise After Lung Transplantation

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2020 · $541,338

## Abstract

7. PROJECT SUMMARY/ ABSTRACT
Lung transplantation is a costly procedure. Estimated costs, from 30 days prior to transplant to 6 months post-
surgery, exceed $1 million per patient and routine medical management costs $50,000 per year thereafter.
Despite this extensive investment, major challenges remain. Prior to transplant, lung transplant recipients
(LTR) self-restrict activity due to severe ventilatory limitation, resulting in reduced muscle mass and qualitative
changes in large exercising skeletal muscles. After transplant, despite improved lung function, prior studies
consistently report LTR fail to reach predicted physical function or physical activity. Further, nearly 70% of LTR
are at risk of developing hypertension within first 5 years due to their immunosuppressive regimen and an
inactive lifestyle can worsen this risk. Consequently, full benefits of transplant may not be achieved. Few
studies have tested ways to engage LTR to self-manage exercise and adopt an active lifestyle. Initiated by an
Early Stage New Investigator, we propose to test Lung Transplant Go (LTGO), a behavioral exercise
intervention that provides individualized exercise training integrated with behavioral coaching for LTR in their
home. Exercise training will focus on assisting LTR to learn and practice exercises to reverse muscle
deconditioning. Behavioral coaching will engage LTR in developing skills to self-manage physical activity in
their daily life and maintain this as a sustained habit using strategies that include incremental goal setting, self-
monitoring and feedback and problem solving. The LTGO intervention consists of two phases: Phase 1.
Intensive home-based exercise training and behavioral coaching via a telerehabilitation platform, VISYTER
(Versatile and Integrated System for Tele-Rehabilitation). Interactive intervention sessions will be delivered to
the home via real time video conferencing (10 sessions within 12 weeks); and Phase 2. Transition to self-
management. Four telephone sessions (1 behavioral contract + 3 monthly counseling sessions) will be
delivered over 12 weeks to provide behavioral coaching and exercise reinforcement. Our exciting pilot work
successfully demonstrated the feasibility, safety and ability of LTGO to improve physical function and physical
activity and was enthusiastically received. We will conduct a two-group randomized controlled trial comparing
LTGO against enhanced usual care (EUC). Participants will be 112 LTR randomized to LTGO or EUC (1:1).
Outcomes will be measured at baseline, and 3 and 6 months post-randomization. Primary outcomes are
physical function (walking ability [6-Minute Walk Test], balance [Berg Balance Scale], lower body strength [30-
second Chair-Stand Test], and quadriceps muscle strength [Biodex System 3 Pro]) and physical activity
(Actigraph GT3X). Secondary outcome is blood pressure control (preventing onset of hypertension or
controlling existing hypertension). Potential mediators will be exercise...

## Key facts

- **NIH application ID:** 9901633
- **Project number:** 5R01NR017196-03
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** ANNETTE J DE VITO DABBS
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $541,338
- **Award type:** 5
- **Project period:** 2018-06-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9901633

## Citation

> US National Institutes of Health, RePORTER application 9901633, Lung Transplant Go (LTGO): Improving Self-Management of Exercise After Lung Transplantation (5R01NR017196-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9901633. Licensed CC0.

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