Quick Comparison Guide of Digital Tools for Physical Activity in Transplant Candidates and Recipients
Here are some websites and apps that can help transplant recipients get active or stay motivated with their physical activity. More details about each one is provided below.
| Digital Tool | Cost | Transplant Specific? | Type of Exercise | Standout Features | Device Compatibility with Wearables* | Community | Customized Workout Plan |
| Re-fit for Life (Website) | Free | Yes | Cardio Strength Stretch | Detailed Transplant-specific advice in the form of a Website | No | No | No |
| BEAM (website) | Premium, 2 week free trial | No, but transplant-related | Cardio Strength Stretch | Live synchronous classes | No | Yes | No |
| EL-Fit (App) | Free | Yes | Cardio Strength Stretch | Exercises for pre-habilitation transplant patients | Yes | No | Yes |
| Strava (App) | Free and Premium | No | Cardio | Clubs and Community | Yes | Yes | No |
| Sworkit (App) | Free and Premium | No | Cardio Strength Stretch | Comprehensive workout and videos | Yes | Yes | Yes |
| JeFit (App) | Free and Premium | No | Strength | Strength training | No | Yes | Yes |
Refit for Life
Refit for life is an excellent resource if you are interested in reaching a healthier lifestyle as a transplant recipient. It’s an online website that has curated information on exercise, diet and mental health specific to transplant recipients. Its exercise page gives great recommendations on proper and safe stretches, a place for people to assess their fitness, and exercise recommendations to do depending on the kind of goal you as a transplant recipient are planning to achieve. Refit for life includes detailed information on the type, frequency, duration, and intensity of the exercises that should be done based on current research.
Not only is ReFit for Life a great resource for exercise, it has a catalog of helpful articles with relationship to nutrition. The saying “you are what you eat” rings true for transplant recipients as much as anyone else, and ReFit for life has recommendations specific for individuals who are post-transplant. Some of the things that they mention include limiting salt to minimize fluid retention, ensuring to stay hydrated, among others.
Mental wellbeing is just as important as physical wellbeing, and ReFit for Life has a page dedicated to tackling emotional stress that may be associated with an organ transplant, This includes family issues, guilt, burden of responsibility, and support systems you can reach out to in times of needed help.
If you are a healthcare professional, the website has a page focused on helping clinicians treat and better understand transplant patients. In this section, they talk about how to assess transplant recipients, the importance of physical activity in transplant recipients specifically, as well as a medical professional community you can post and share ideas in.
Finally, ReFit for life has an important section describing the risks associated with exercise, and the signs and symptoms transplant recipients should be aware, and the appropriate steps. Specifically, it will tell you when you should not, slow down, or stop if already exercising, to make sure that your journey to a healthy lifestyle is also safe.
EL Fit
EL-Fit is an app designed for patients undergoing pre-habilitation prior to liver transplantation. It is an exercise app designed to facilitate exercise training within end-stage liver disease patients and those with cirrhosis. Cirrhosis and advanced liver disease may cause patients to lose strength and mobility, adn even become frail while they wait for the transplant. The app allows individuals to train at home, and be paired with a personal activity tracker (FitBit and Apple Watch). EL-FIT is capable of providing an individualized workout plan based on training level, as well as education videos for corresponding intensity and exercise type. Furthermore, it’s tracking is able to take into account daily steps, heart rate, and sleep time. Information such as nutrition is also available. Behavior-motivating features are included as well, with a leaderboard, earned badges, social contacts, emojis, and can be linked with an exercise professional to provide encouraging feedback., the app can be linked with a clinician or healthcare provider that is able to continuously monitor the individual. Considering the dire need to increase physical activity, EL-FIT aims to fill the gap between a doctor’s recommendation to exercise and the prescription by an exercise professional experienced with advanced liver disease patients.
In order to use the app, a prescription form must be submitted to the app developers, including some limited information on the individuals’ medical history, hemoglobin, bilirubin, creatine, INR, sodium, etc.
BEAM
BEAM is a web-resource that provides exercise programs for people with various chronic conditions, including chronic kidney disease and cystic fibrosis, which maybe relevant for transplant candidates.
BEAM seeks to improve the emotional and physical health of individuals living with chronic diseases through exercise and education. There are general programs that are applicable to anyone (examples include “Introduction to Yoga” and “Cardio Challenge”), as well as condition-specific programs such as “Yoga for Airway Clearance”, designed specifically for people with cystic fibrosis. BEAM has professional exercise videos, a diversity of exercises and allows for choices in the types of exercises you select. One unique feature of BEAM is that it offers live and on-demand classes which are led by trained specialists. These exercise sessions can include a combination of high-intensity interval training (HIIT), strength, yoga, and dance. The exercises are designed to help improve posture, increase flexibility, and improve fitness.
There are groups available through BEAM that are based at certain clinical centres or through a BEAM instructor and managed by their team.
BEAM programs are made available through a subscription however there are several partner organizations that provide subscriptions for their members. There is also a 2-week free trial available.
Strava
Strava is Swedish for “strive”, and is a mobile app found on either IOS or the app store specifically designed to track your running and cycling in a community environment. Strava offers analysis of your activity performance by recording the distance you travel by cycling, walking or running. It’s made up of several tabs in the mobile app: recording activity, a home feed, training and performance, routes, and challenges. The activity feed can show you the physical activity of people on your “friends list”, photos, posts, and description of each activity – you can think of Strava as the social media for exercise! A great feature in Strava is the “Groups page” (shown below), where it contains challenges and clubs that you can join, which could be people of similar area, culture, occupation, and there are even clubs specific to organ transplant recipients.
Another great feature of Strava is that it comes with a highly detailed map that you can use to customize designed routes. For instance, you can select if you want a route suited for running, cycling, walking, whether it’s hilly/flat, , paved, or off-road. Hence, it’s great for if you’re on holiday and want to get some exercise in! In addition, it has a “segments feature” that allows you to compare your travel time between different parts of the route. Finally, we can’t forget to mention the excellent performance tracking that Strava has: heart rate, speed, distance, elevation change, power, and more (certain statistics may depend on the device that you use).
Limitations to keep in mind is that this app is not transplant specific, although there is the potential for some customizability to fit the needs of transplant recipients. In addition, it is mainly a tool for runners, walkers, and cyclists, as there is the absence of strength training
Sworkit
Sworkit is a great app to develop a holistic exercise regimen. Specifically, Sworkit has exercises designed specifically for aerobic, strength/resistance, and flexibility at the appropriate frequency, intensity, and type of workout. Starting the app is very simple, as the 3 broad categories of Sworkit are strength, cardio, yoga, and stretching. Then, there are a series of questions posed to the user that will help Sworkit to get a personalized exercise plan for each individual. This includes changing the duration of your workout, the intensity, or which muscles are targeted. Furthermore, for each exercise there is an interactive video that is displayed to show how to do the workout. There are also hundreds of different exercises and variations that can be done in Sworkit, which ensures that there is enough variety and an individual does not get too bored of the app. Alternatively, if you want to set up your own program, you can drag and drop specific exercises into a custom made program, or use a template program provided by Sworkit.
Like many other apps, Sworkit can be used to track your progress, and can also connect to Apple’s Health app, Google Fit, and MyFitnessPal in order to track workouts. Sworkit consist of a monthly and annual subscription plan in order to unlock full features, although some features can be used for free. Furthermore, the apps do not have the ability to dynamically adjust to a new fitness level, whereas some apps will let you rate the difficulty of the exercise so that subsequent exercises are of appropriate difficulty. Finally, Sworkit is not specific to transplant recipients, but can be easily customized to individuals.
JeFit
The primary purpose of JeFit is to create an easy way for users to track strengthening exercises. The app has more than 1300 different exercise variations, with an accompanying video and description for each. In addition, the app also has to ability for you to create custom workouts by combining different exercises together, or you can search for a particular workout made by another user and make it your own. This personalization extends beyond the workouts you do, as it will also ask for the number of days you want to train, preferred location, goal, and fitness level. One unique thing about Jefit is that it includes exercises with weights so this is a great app to accompany you when you go to the gym or if you have weights at home. Like other workout apps, it contains a progress tracker and charts.
JeFit also offers the option to create groups, as you can add friends and see each other’s results and progress if they make their profile public. It should be noted that you cannot create groups in JeFit, however, the app allows you to share on social media platforms like YouTube, and Facebook. It should be noted that there is no dieting, or much cardio/aerobic exercises available in JeFit. JeFit offers three different levels of membership, with a free tier (which has ads and some limitations to access charts and custom workouts); the paid tiers have monthly or annual fees. Jefit is available on the IOS and android store, as well as android smartwatch, Apple watch, and their online website http://www.jefit.com.
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