BACKGROUND: Exercise is safe and effective in the short-term following pulmonary embolism. To date, little is known about the long-term effects. OBJECTIVES: The aim of the study was to investigate whether the effects of exercise-based rehabilitation are maintained 6 months after completion in patients with persistent dyspnea following pulmonary embolism when compared with usual care. METHODS: A 2-center, randomized controlled trial compared 8 weeks of exercise-based rehabilitation with usual care. Patients were reassessed postintervention and 6 months later. Exercise capacity was measured with the incremental shuttle walk test (ISWT). Dyspnea was assessed with the Shortness of Breath Questionnaire, and health-related quality of life was assessed with disease-specific (Pulmonary Embolism Quality of Life Questionnaire) and generic questionnaires. RESULTS: In total, 159 of 211 randomized patients attended follow-up 6 months postintervention. The significant improvement on the ISWT in the rehabilitation group was maintained at the 6-month follow-up (96 m; SE 15 m; 95% CI 66 to 127). There were no changes on the ISWT in the control group at either time point. From postintervention to 6x-month follow-up, the rehabilitation group had further improvements in dyspnea compared with the control group (-3 points; SE 1.4; 95% CI -6 to -1; p = 0.02). Health-related quality of life improved in both groups although superior improvements were seen in the rehabilitation group. CONCLUSION: The improvement in exercise capacity after 8 weeks of exercise-based rehabilitation in patients with pulmonary embolism and persistent dyspnea was maintained at the 6-month follow-up, while no improvement was observed in the control group, highlighting the relevance of offering rehabilitation to these patients.

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