Abstract
The aim of this study was to evaluate the effects of a 6-month combined aerobic and strength exercise training program on functional and psychological aspects and health-related quality of life in patients with PH and to evaluate its longer-term impact. In total, 22 stable patients (mean age 53.9 ± 13.8, 13 female) with pulmonary hypertension of World Health Organization (WHO) class I-III participated in a nine-month study. They were randomly assigned into two groups: Group A participated in a 6-month combined aerobic and strength exercise training program, whereas Group B remained untrained. All patients underwent physical and psychological assessment at baseline and at month 6 (after completing the exercise program) and physical assessment after 9 months (3 months posttraining). After the 6-month exercise training program, patients of Group A significantly improved their physical (6MWD, STS 10 rep, STS 20 rep, TUG, lower limb strength, cardiopulmonary exercise time, METs, peak VO2, VCO2, and VE/VCO2 slope) and psychological aspects (SF-36, STAI, and BDI). Between the two groups, differences were observed at the 6MWD (95% CI: 36.2-64.6, η2 = 0.72), STS 10 rep (95% CI: 6.6-2.2, η2 = 0.4), STS 20 rep (95% CI: 10.8-2.4, η2 = 0.34), lower limb strength (95% CI: 7.2-3.6, η2 = 0.38), cardiopulmonary exercise time (95% CI: 0.1-3.3, η2 = 0.2), and VCO2 (95% CI: 0.1-0.5, η2 = 0.2). Additionally, psychological changes were noted at SF-36, PCS (95% CI: 3.6-14.8, η2 = 0.35), MCS (95% CI: 1.3-16.1, η2 = 0.22), TCS (95% CI: 1.3-16.1, η2 = 0.22), and STAI (95% CI: 1.8-28.2, η2 = 0.18). The favorable results of exercise were maintained at the 3-month posttraining follow-up assessment. No exercise-induced complications were observed throughout the study. In conclusion, a long-term exercise training program is a safe and effective intervention to improve functional status, psychological aspects, and health-related quality of life in patients with PH.
Highlights
Precapillary pulmonary hypertension (PH) is a chronic progressive disease in which patients suffer from exertional dyspnea and fatigue, increasing inactivity and physical deconditioning that further exacerbates their symptoms
Despite advances in pharmaceutical therapies, which led to significant improvement in exercise capacity, exertional dyspnea and fatigue remain basic clinical aspects and result in difficulty coping with everyday activities
Inclusion criteria were as follows: stable patients with precapillary PH classified as group 1 or group 4 inoperable disease, diagnosed according to current guidelines [7]; World Health Organization (WHO) functional class ≤III; and stable medical and pharmaceutical therapy for at least three months before randomization
Summary
Precapillary pulmonary hypertension (PH) is a chronic progressive disease in which patients suffer from exertional dyspnea and fatigue, increasing inactivity and physical deconditioning that further exacerbates their symptoms. The sensation of dyspnea results to a vicious cycle, in which the avoidance of physical activity leads to exercise capacity limitations with psychological status worsening that further limit patients’ health-related quality of life (HRQoL) [2] and engagement to any kind of physical activity [3,4,5]. This may result in physical deconditioning and further increase of dyspnea. The aim of this study was to evaluate the effects of a 6-month combined aerobic and strength outpatient exercise training program on physical functioning, level of anxiety and depression, and HRQoL status in patients with precapillary PH, as well as its impact on physical functioning 3 months after program termination
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