Körperliches Training bei pulmonaler Hypertonie – ein systematisches Review mit Metaanalyse

Glöckl, R; Schneeberger, Tessa; Boeselt, Tobias; Kenn, Klaus; Koczulla, Andreas Rembert; Held, Matthias; Oberhoffer, Renate; Halle, Martin

doi:10.1055/a-1005-8678

Cited by 8 publications

(2 citation statements)

References 42 publications

(52 reference statements)

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“…The effectiveness of the program is comparable or greater than that reported in previously published interventions based mainly on closely supervised rehabilitation in medical facilities. The impact of physical training on functional parameters has been revealed in meta-analyses [ 12 , 25 , 26 ] which demonstrated, inter alia, improvements in 6MWT (6MWD) by 53–72 m, peak VO 2 /kg in the range of 1.5–2.2 ml/min/kg, and workload by 14.9 W [ 9 ]. Our study, compared with these analyses, showed an improvement in 6MWD by 71.4 m after the intervention period, revealing equally high effectiveness.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of a simple home-based rehabilitation program in pulmonary arterial hypertension: an interventional pilot study

Wojciuk

Ciołkiewicz

Kuryliszyn-Moskal

et al. 2021

BMC Sports Sci Med Rehabil

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Background Rehabilitation plays an important role in the management of patients with pulmonary arterial hypertension (PAH) and current guidelines recommend implementation of a monitored individualized exercise training program as adjuvant therapy for stable PAH patients on optimal medical treatment. An optimal rehabilitation model for this group of patients has not yet been established. This randomized prospective study assessed the effectiveness and safety of a 6-month home-based caregiver-supervised rehabilitation program among patients with pulmonary arterial hypertension. Methods A total of 39 patients with PAH were divided into two groups: intervention group (16 patients), subjected to a 6-month home-based physical training and respiratory rehabilitation program adapted to the clinical status of participants, and control group (23 patients) who did not perform physical training. The 6-min walk test (6MWT), measurement of respiratory muscle strength, quality of life assessment (SF-36, Fatigue Severity Scale – FSS) were performed before study commencement, and after 6 and 12 months. Adherence to exercise protocol and occurrence of adverse events were also assessed. Results Physical training significantly improved 6MWT distance (by 71.38 ± 83.4 m after 6 months (p = 0.004), which remained increased after 12 months (p = 0.043), and respiratory muscle strength after 6 and 12 months (p < 0.01). Significant improvement in quality of life was observed after the training period with the use of the SF-36 questionnaire (Physical Functioning, p < 0.001; Role Physical, p = 0.015; Vitality, p = 0.022; Role Emotional, p = 0.029; Physical Component Summary, p = 0.005), but it did not persist after study completion. Adherence to exercise protocol was on average 91.88 ± 14.1%. No serious adverse events were noted. Conclusion According to study results, the home-based rehabilitation program dedicated to PAH patients is safe and effective. It improves functional parameters and quality of life. Strength of respiratory muscles and 6MWD remain increased 6 months after training cessation. Trial registration ClinicalTrials.gov, NCT03780803. Registered 12 December 2018

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Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of a simple home-based rehabilitation program in pulmonary arterial hypertension: an interventional pilot study

Wojciuk

Ciołkiewicz

Kuryliszyn-Moskal

et al. 2021

BMC Sports Sci Med Rehabil

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“…Despite of severe symptoms and limitations in exercise capacity, until recently physical activity including exercise training has often been discourgaed in patients with pulmonary artery hypertension, particularly in those with more advanced disease due to safety concerns. 96 In the meantime, however, exercise training has been shown to be safe and efficacious in these patients, 97 and international guidelines recommend its use in experienced centers for patients who are clinically stable and on optimal pharmacological treatment. 96 It has further been observed that after successful pulmonary endarterectomy surgery, patients can still have limited exercise capacity, 98 especially if pulmonary hemodynamics do not completely normalize.…”

Section: Rehabilitation For Patients With Chronic Thromboembolic Pulm...mentioning

confidence: 99%

Addressing the changing rehabilitation needs of patients undergoing thoracic surgery

Langer

2021

Chron Respir Dis

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The rehabilitation needs of individuals undergoing thoracic surgery are changing, especially as surgical management is increasingly being offered to patients who are at risk of developing functional limitations during and after hospital discharge. In the past rehabilitative management of these patients was frequently limited to specific respiratory physiotherapy interventions in the immediate postoperative setting with the aim to prevent postoperative pulmonary complications. In the past two decades, this focus has shifted toward pulmonary rehabilitation interventions that aim to improve functional status of individuals, both in the pre- and (longer-term) postoperative period. While there is increased interest in (p)rehabilitation interventions the majority of thoracic surgery patients are however currently on their own with respect to progression of their exercise and physical activity regimens after they have been discharged from hospital. There are also no formal guidelines supporting the referral of these patients to outpatient rehabilitation programs. The current evidence regarding rehabilitation interventions initiated before, during, and after the hospitalization period will be briefly reviewed with special focus on patients undergoing surgery for lung cancer treatment and patients undergoing lung transplantation. More research will be necessary in the coming years to modify or change clinical rehabilitation practice beyond the acute admission phase in patients undergoing thoracic surgery. Tele rehabilitation or web-based activity counseling programs might also be interesting emerging alternatives in the (long-term) postoperative rehabilitative treatment of these patients.

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Exercise and sports after COVID‐19—Guidance from a clinical perspective

et al. 2021

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SARS-CoV-2 infection has emerged as not only a pulmonary but also potentially multiorgan disease, which may cause long-term structural damage of different organ systems including the lung, heart, vasculature, brain, liver, kidney, or intestine. As a result, the current SARS-CoV-2/COVID-19 pandemic will eventually yield substantially increased numbers of chronically diseased patients worldwide, particularly suffering from pulmonary fibrosis, post-myocarditis, chronic heart failure, or chronic kidney disease.Exercise recommendations for rehabilitation are complex in these patients and should follow current guidelines including standards for pre-exercise medical examinations and individually tailored exercise prescription. It is of utmost importance to start exercise training at an early stage after COVID-19 infection, but at the same time paying attention to the physical barriers to ensure safe return to exercise. For exercise recommendations beyond rehabilitation programs particularly for leisure time and elite athletes, more precise advice is required including assessment of sports eligibility and specific returnto-sports exercise programs. Because of the current uncertainty of long-term course of SARS-CoV-2 infection or COVID disease, long-term follow-up seems to be necessary.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Körperliches Training bei pulmonaler Hypertonie – ein systematisches Review mit Metaanalyse

Cited by 8 publications

References 42 publications

Effectiveness and safety of a simple home-based rehabilitation program in pulmonary arterial hypertension: an interventional pilot study

Effectiveness and safety of a simple home-based rehabilitation program in pulmonary arterial hypertension: an interventional pilot study

Addressing the changing rehabilitation needs of patients undergoing thoracic surgery

Exercise and sports after COVID‐19—Guidance from a clinical perspective

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