AIMS: Pulmonary arterial hypertension (PAH) is characterized by exercise intolerance, dyspnea and fatigue symptoms. Therefore, PAH patients may experience more inconvenience performing activities of daily living (ADL). The aim of this study was to examine the effects of Kettlebell exercise training (KET) on functional capacity, metabolic cost and cardiovascular responses in PAH patients during ADL. METHODS: Thirty-two PAH patients were separated into the intervention Group (IG) or control group (CG). The IG participated in KET, 3 days/week for 8 weeks, and the CG received no exercise program. Responses were measured using a mobile ergospirometer during the 6-min walk test (6MWT) and ADLs. Peripheral muscle strength was evaluated using a hand dynamometer; dyspnea with the Modified Medical Research Council (mMRC) and London Chest Activity of Daily Living (LCADL); fatigue with the Fatigue Severity Scale (FSS); physical activity with the International Physical Activity Questionnaire-Short Form (IPAQ-SF); anxiety and depression with the Hospital Anxiety-Depression Scale (HADS); quality of life with the EmPHasis-10, and sleep quality with the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The IG showed significant improvement in 6MWT (p < 0.01), task oxygen uptake (p = 0.02) and peakVO2 (p < 0.01). Relative task-related oxygen uptake (% of peakVO2) and dyspnea improved in ADLs (p < 0.05). Peripheral muscle strength significantly improved (p < 0.05). Significant improvements were seen in the EmPHasis-10, FSS, mMRC, IPAQ-SF, HADS-A and HADS-D scores (p < 0.05). CONCLUSION: KET improved functional capacity, quality of life, peripheral muscle strength, fatigue, dyspnea, physical activity level, anxiety and depression in PAH patients and reduced dyspnea in many activities of daily life.

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