Ten weeks of brisk treadmill walking improved 6MWT distance, cardiorespiratory function, and patient-reported quality of life in female patients with group 1 PH.
Summary
Objective
To investigate the effectiveness of an exercise intervention for decreasing fatigue severity and increasing physical activity in individuals with pulmonary arterial hypertension (PAH). A small, phase 2 randomized clinical trial of the effect of aerobic exercise training on fatigue severity and physical activity in patients with idiopathic or PAH associated with other conditions was conducted.
Methods
Twenty-four patients with PAH (24 female; age: 54.4 ± 10.4 years; BMI: 30.8 ± 7.2 kg/m2) participated in the study. A convenience sample was recruited in which 9% (28 of 303) of screened patients were enrolled. The project was carried out in a clinical pulmonary rehabilitation clinic during existing pulmonary rehabilitation program sessions.
Patients with PH were randomized into a 10-week program that consisted of patient education only or patient education plus an aerobic exercise-training regimen. Both groups received 20 lectures, two per week over the 10-weeks, on topics related to PAH and its management. The aerobic exercise training consisted of 24–30 sessions of treadmill walking for 30–45 min per session at an intensity of 70–80% of heart rate reserve, three days per week over the 10 weeks.
Results
After 10-weeks of intervention, patients receiving aerobic exercise training plus education reported routinely engaging in higher levels of physical activity (p < 0.05) and a decrease in fatigue severity (p = 0.03). Patients in the education only group did not report changes in fatigue severity or participation in physical activity.
Conclusions
The 10-week aerobic exercise training intervention resulted in increased physical activity and decreased fatigue in individuals with PAH.
Background: This prospective, randomized controlled trial examined the effect of progressive muscle relaxation (PMR) training on anxiety and depression in patients with chronic breathing disorders receiving pulmonary rehabilitation (PR). Methods: Eighty-three subjects with chronic breathing disorders entering the 8-week PR program were randomly assigned to a standard care or intervention group. The standard program included 2 days per week of exercise, education and psychosocial support delivered by a multidisciplinary team. The intervention group received additional sessions of PMR training using a prerecorded tape for 25 min/week during weeks 2–8. Primary outcome measures were levels of anxiety and depression evaluated by the Hospital Anxiety and Depression Scale. Results: For anxiety, there was an overall significant improvement within each group over time (p < 0.0001). There was no statistically significant group-time interaction (p = 0.17) and no statistically significant difference between the groups (p = 0.22), despite lower scores for every time point in the PMR group. For depression, there was an overall significant improvement within each group over time (p < 0.0001). Although the difference between the groups (p = 0.09) and group-time interaction (p = 0.07) did not reach statistical significance, the results again favored the PMR group for weeks 5–8. Depression scores were lower for the PMR throughout weeks 1–8. Conclusions: PR is effective in reducing anxiety and depressive level in chronic lung patients. Our findings suggest that adding structured PMR training to a well-established PR program may not confer additional benefit in the further reduction of anxiety and depression in patients receiving PR.
PURPOSE
To characterize the cardiorespiratory response to exercise before and after aerobic exercise training in patients with interstitial lung disease (ILD).
METHODS
We performed a clinical study, examining 13 patients (New York Heart Association/World Health Organization Functional Class II or III) before and after 10-weeks of supervised treadmill exercise walking, at 70–80% of heart rate reserve, 30–45 minutes per session, 3 times per week. Outcome variables included measures of cardiorespiratory function during a treadmill cardiopulmonary exercise test (tCPET), with additional near infrared spectroscopy measurements of peripheral oxygen extraction and bioimpedance cardiography measurements of cardiac output. 6-minute walk test distance (6MWD) was also measured.
RESULTS
All subjects participated in at least 24 of their 30, scheduled exercise sessions with no significant adverse events. After training, the mean 6MWD increased by 52±48 meters (P=.001), peak tCPET time increased by 163±130 seconds (P=.001), and time to achieve gas exchange threshold increased by 145±37 seconds (P<.001). Despite a negligible increase in peak oxygen uptake (VO2) with no changes to cardiac output, the overall work rate/VO2 relationship was enhanced after training. Muscle oxygen extraction increased by 16% (P=.049) after training.
CONCLUSION
Clinically significant improvements in cardiorespiratory function were observed after aerobic exercise training in this group of subjects with ILD. These improvements appear to have been mediated by increases in the peripheral extraction of oxygen rather than changes in oxygen delivery.
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