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Long-term effect of an exercise training program on physical functioning and quality of life in pulmonary hypertension: a randomized controlled trial
Kagioglou O, Mouratoglou S-A, Giannakoulas G, Kapoukranidou D, Anifanti M, Deligiannis A, Skarbaliene A, Razbadauskas A, Kouidi E
BioMed Research International 2021;(8870615):Epub
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 to 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 to 64.6, partial-eta2 = 0.72), STS 10 rep (95% CI 6.6 to 2.2, partial-eta2 = 0.4), STS 20 rep (95% CI 10.8 to 2.4, partial-eta2 = 0.34), lower limb strength (95% CI 7.2 to 3.6, partial-eta2 = 0.38), cardiopulmonary exercise time (95% CI 0.1 to 3.3, partial-eta2 = 0.2), and VCO2 (95% CI 0.1 to 0.5, partial-eta2 = 0.2). Additionally, psychological changes were noted at SF-36, PCS (95% CI 3.6 to 14.8, partial-eta2 = 0.35), MCS (95% CI 1.3 to 16.1, partial-eta2 = 0.22), TCS (95% CI 1.3 to 16.1, partial-eta2 = 0.22), and STAI (95% CI 1.8 to 28.2, partial-eta2 = 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.

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