{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:25:04Z","timestamp":1783031104222,"version":"3.54.6"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T00:00:00Z","timestamp":1724371200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>There is widespread recognition that many transplant recipients struggle to become and remain physically active. However, some transplant recipients do undertake strenuous training and significant physical activity (PA) and participate in intensive sports.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Aim<\/jats:title>\n<jats:p>This study sought to understand facilitators and barriers to be physically active for Transplant Athletes (TXA) compared to a group of Dutch transplantees. This explorative mixed methods study analysed race performance and interview data from TxA who participated in cycling and\/or the sprint triathlon at the World Transplant Games 2023, and compared their lived experiences in terms of barriers and facilitators of PA with those of 16 transplantees in a study from the Netherlands previously published in this journal.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Using Patient and Public Involvement and engagement (PPI), race data from World Transplant Games 2023 and subsequent in-depth interviews were used from 27 TxA. A visual artefact of barriers and facilitators from the previous Dutch study was used to prompt identification and discussion of barriers and facilitators of PA. Interview data were coded by three coders.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>Many of the barriers to PA previously reported by Dutch transplant recipients were not shared by the majority of TxA in this study. The TxA in this study reported significantly lower physical limitations, lower fear to undertake exercise, and no comorbidity issues for TxA. Furthermore, TxA perceived they received substantial social support, had the strength to do PA, and were in control of their weight.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Several TxA reported a lack of understanding from medical and other professionals about the appropriate intensity of PA. An evidence-based framework of PA for transplant recipients and transplant athletes is needed for safe and appropriate PA.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0307095","type":"journal-article","created":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T17:55:33Z","timestamp":1724435733000},"page":"e0307095","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Barriers and facilitators to physical activity: A comparative analysis of transplant athletes competing in high intensity sporting events with other transplant recipients"],"prefix":"10.1371","volume":"19","author":[{"given":"Bart","family":"Rienties","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6826-9418","authenticated-orcid":true,"given":"Elaine","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perry","family":"Judd","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2336-7617","authenticated-orcid":true,"given":"Ben","family":"Oakley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liset H. M.","family":"Pengel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keetie","family":"Roelen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Topley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,8,23]]},"reference":[{"key":"pone.0307095.ref001","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.ptsp.2019.07.003","article-title":"Therapeutic perceptions in management of transplant athletes at transplant games","volume":"39","author":"S Leddington Wright","year":"2019","journal-title":"Physical Therapy in Sport"},{"issue":"5","key":"pone.0307095.ref002","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/TP.0b013e31827a3d3e","article-title":"Exercise Training in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis","volume":"95","author":"M Didsbury","year":"2013","journal-title":"Transplantation"},{"issue":"1","key":"pone.0307095.ref003","doi-asserted-by":"crossref","DOI":"10.1097\/TP.0000000000004313","article-title":"Does Exercise Training Improve Physical Fitness and Health in Adult Liver Transplant Recipients? A Systematic Review and Meta-analysis","volume":"107","author":"S De Smet","year":"2023","journal-title":"Transplantation"},{"issue":"1","key":"pone.0307095.ref004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2174\/1874418420130605002","article-title":"Transplant Recipients\u2019 Experience of Participation at the World Transplant Games in Gothenburg 2011: A Study of Psychological Well-being","volume":"7","author":"U Johnson","year":"2013","journal-title":"The Open Transplantation Journal"},{"issue":"9","key":"pone.0307095.ref005","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0162725","article-title":"Perceived Barriers to and Facilitators of Physical Activity in Recipients of Solid Organ Transplantation, a Qualitative Study","volume":"11","author":"EJ van Adrichem","year":"2016","journal-title":"PLOS ONE"},{"issue":"9","key":"pone.0307095.ref006","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1161\/CIRCULATIONAHA.107.185649","article-title":"Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association","volume":"116","author":"WL Haskell","year":"2007","journal-title":"Circulation"},{"issue":"8","key":"pone.0307095.ref007","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1093\/ptj\/pzy055","article-title":"Physical Activity, Sedentary Time, and Associated Factors in Recipients of Solid-Organ Transplantation","volume":"98","author":"EJ van Adrichem","year":"2018","journal-title":"Physical Therapy"},{"key":"pone.0307095.ref008","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ypmed.2015.08.005","article-title":"Levels of physical activity among adults 18\u201364 years old in 28 European countries","volume":"81","author":"V Gerovasili","year":"2015","journal-title":"Preventive Medicine"},{"issue":"1","key":"pone.0307095.ref009","doi-asserted-by":"crossref","first-page":"e001248","DOI":"10.1136\/bmjsem-2021-001248","article-title":"Characteristics of transplant athletes competing at national and international transplant games","volume":"8","author":"T Hames","year":"2022","journal-title":"BMJ Open Sport & Exercise Medicine"},{"issue":"3","key":"pone.0307095.ref010","first-page":"S481","article-title":"Transplant recipients\u2019 motivational orientation towards sport participation and physical activity enjoyment at the 2019 World Transplant Games in Newcastle-Gateshead UK","volume":"15","author":"J Jooste","year":"2020","journal-title":"Journal of Human Sport and Exercise"},{"key":"pone.0307095.ref011","author":"D Rogerson","year":"2023","journal-title":"An Initial Exploration of Fatigue as a Predictor of Quality of Life in Transplant Athletes Competing at National and International Events"},{"key":"pone.0307095.ref012","unstructured":"World Transplant Games. Results of World Transplant Games Perth 2023 Perth2023. Available from: https:\/\/worldtransplantgames.org\/results\/."},{"key":"pone.0307095.ref013","doi-asserted-by":"crossref","first-page":"100345","DOI":"10.1016\/j.dcm.2019.100345","article-title":"Strava as a discursive field of practice: Technological affordances and mediated cycling motivations","volume":"34","author":"DJ Rivers","year":"2020","journal-title":"Discourse, Context & Media"},{"issue":"10","key":"pone.0307095.ref014","doi-asserted-by":"crossref","first-page":"639","DOI":"10.2165\/00007256-200434100-00002","article-title":"Physical activity for people with a disability: a conceptual model","volume":"34","author":"HP van der Ploeg","year":"2004","journal-title":"Sports Med"},{"issue":"8","key":"pone.0307095.ref015","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1056\/NEJMra2014530","article-title":"Long-term survival after kidney transplantation","volume":"385","author":"S Hariharan","year":"2021","journal-title":"New England Journal of Medicine"},{"issue":"1","key":"pone.0307095.ref016","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s40900-019-0160-4","article-title":"Innovating public engagement and patient involvement through strategic collaboration and practice","volume":"5","author":"L Holmes","year":"2019","journal-title":"Research Involvement and Engagement"},{"issue":"1","key":"pone.0307095.ref017","doi-asserted-by":"crossref","first-page":"307","DOI":"10.16993\/sjdr.696","article-title":"Insider, Outsider or an In-Betweener? Epistemological Reflections of a Legally Blind Researcher on Conducting Cross-National Disability Research","volume":"22","author":"G Chhabra","year":"2020","journal-title":"Scandinavian Journal of Disability Research"},{"issue":"9","key":"pone.0307095.ref018","doi-asserted-by":"crossref","first-page":"e055428","DOI":"10.1136\/bmjopen-2021-055428","article-title":"Patient and public involvement in the development of clinical practice guidelines: a scoping review","volume":"12","author":"EA Bryant","year":"2022","journal-title":"BMJ Open"},{"issue":"6","key":"pone.0307095.ref019","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"International Journal for Quality in Health Care"},{"key":"pone.0307095.ref020","first-page":"37","article-title":"Physical Exercise After Solid Organ Transplantation: A Cautionary Tale","author":"D Stylemans","year":"2024","journal-title":"Transplant International"},{"key":"pone.0307095.ref021","volume-title":"The Palgrave Handbook of Multiple and Multi-Dimensional Educational and Life Transitions","author":"B Rienties","year":"2025"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0307095","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,23]],"date-time":"2024-08-23T17:55:54Z","timestamp":1724435754000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0307095"}},"subtitle":[],"editor":[{"given":"Heather","family":"Macdonald","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,8,23]]},"references-count":21,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0307095","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,23]]}}}