Exercise-Based Rehabilitation for Pulmonary Hypertension

Summary

A Cochrane review [Abstract] 1 included 14 studies with a total of 462 subjects with pulmonary hypertension (PH). Data was extracted from 11 studies. Most participants were women and classified as Group I pulmonary arterial hypertension (PAH). Mean age of participants ranged from 35 to 68 years. Study duration ranged from 3 to 25 weeks. Exercise programmes included both inpatient- and outpatient-based rehabilitation that incorporated both upper and lower limb exercise.

The mean 6-minute walk distance following exercise training was 48.52 m higher than control (95% CI 33.42 to 63.62 m, statistical heterogeneity I² =72%; 11 studies, n=418). The mean peak oxygen uptake was 2.07 ml/kg/minute higher (95% CI 1.57 to 2.57 ml/kg/min; statistical heterogeneity I² =67%; 7 studies, n=314) and the mean peak power in the intervention groups was 9.69 W higher (95% CI 5.52 to 13.85 W; statistical heterogeneity I² =71%; 5 studies, n=226) compared to control group. The mean change in HRQoL for the SF-36 physical component score was 3.98 points higher (95% CI 1.89 to 6.07 points; 5 studies, n=187) and for the SF-36 mental component score was 3.60 points higher (95% CI 1.21 to 5.98 points; 5 studies, n=186).

There were similar effects in the subgroup analyses for participants with Group 1 PH versus studies of groups with mixed PH. The mean reduction in mean pulmonary arterial pressure following exercise-based rehabilitation was 9.29 mmHg (95% CI −12.96 to −5.61; 2 studies, n=133). Three studies reported 5 serious adverse events, but exercise-based rehabilitation was not associated with an increased risk of serious adverse event (11 studies, n=439).