Effects of Exercise Training in Patients With Persistent Dyspnoea After Pulmonary Embolism
abstract
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Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
Persistent dyspnoea, functional limitations and reduced quality of life (QoL) are common after pulmonary embolism (PE). Rehabilitation is a potential treatment option, but the scientific evidence is limited.
RESEARCH QUESTION
Does an exercise-based rehabilitation programme improve exercise capacity in PE survivors with persistent dyspnoea?
STUDY DESIGN AND METHODS
We conducted a randomized controlled trial at two hospitals. Patients with persistent dyspnoea after PE diagnosed 6-72 months earlier, without cardiopulmonary comorbidities, were randomized 1:1 to either rehabilitation or control group. The rehabilitation programme consisted of two weekly sessions of physical exercise for 8 weeks, and one educational session. The control group received usual care. The primary endpoint was the difference in Incremental Shuttle Walk Test (ISWT) between groups at follow-up. Secondary endpoints included differences in Endurance Shuttle Walk Test (ESWT), QoL (EQ-5D and Pulmonary Embolism-QoL questionnaires) and dyspnoea (Shortness of Breath questionnaire) RESULTS: In total 211 subjects were included: 108 (51%) were randomized to the rehabilitation group and 103 (49%) to the control group. At follow-up, participants allocated to the rehabilitation group performed better on the ISWT compared with the control group (mean difference 53.0 meters, 95% CI:17.7-88.3, P=0.0035). The rehabilitation group reported better score on the Pulmonary Embolism-QoL questionnaire (mean difference -4%, 95% CI:-9%-0%, P=0.041) at follow-up, but there were no differences in generic QoL, dyspnoea scores, or the ESWT. No adverse events occurred during the intervention.
INTERPRETATION
In patients with persistent dyspnoea following PE, those who underwent rehabilitation had better exercise capacity at follow-up than those who received usual care. Rehabilitation should be considered in patients with persistent dyspnoea following PE, though further research is needed to assess the optimal patient selection, timing, mode and duration of rehabilitation.
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Additional Info
Disclosure statements are available on the authors' profiles:
The effects of exercise training in patients with persistent dyspnoea after pulmonary embolism: a randomized controlled trial
Chest 2023 May 04;[EPub Ahead of Print], Ø Jervan, S Haukeland-Parker, J Gleditsch, M Tavoly, FA Klok, K Steine, HH Johannessen, MA Spruit, D Atar, R Holst, AEA Dahm, PA Sirnes, K Stavem, W GhanimaFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.