TY - JOUR
T1 - The Effects of Exercise Training in Patients With Persistent Dyspnea Following Pulmonary Embolism
T2 - A Randomized Controlled Trial
AU - Jervan, Øyvind
AU - Haukeland-Parker, Stacey
AU - Gleditsch, Jostein
AU - Tavoly, Mazdak
AU - Klok, Frederikus A
AU - Steine, Kjetil
AU - Johannessen, Hege Hølmo
AU - Spruit, Martijn A
AU - Atar, Dan
AU - Holst, René
AU - Astrup Dahm, Anders Erik
AU - Sirnes, Per Anton
AU - Stavem, Knut
AU - Ghanima, Waleed
PY - 2023/10
Y1 - 2023/10
N2 - Background: Persistent dyspnea, functional limitations, and reduced quality of life (QoL) are common following pulmonary embolism (PE). Rehabilitation is a potential treatment option, but the scientific evidence is limited. Research Question: Does an exercise-based rehabilitation program improve exercise capacity in PE survivors with persistent dyspnea? Study Design and Methods: This randomized controlled trial was conducted at two hospitals. Patients with persistent dyspnea following PE diagnosed 6 to 72 months earlier, without cardiopulmonary comorbidities, were randomized 1:1 to either the rehabilitation or the control group. The rehabilitation program consisted of two weekly sessions of physical exercise for 8 weeks and one educational session. The control group received usual care. The primary end point was the difference in Incremental Shuttle Walk Test between groups at follow-up. Secondary end points included differences in the Endurance Shuttle Walk Test (ESWT), QoL (EQ-5D and Pulmonary Embolism-QoL questionnaires) and dyspnea (Shortness of Breath questionnaire). Results: A total of 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 m; 95% CI, 17.7-88.3; P =.0035). The rehabilitation group reported better scores on the Pulmonary Embolism-QoL questionnaire (mean difference, –4%; 95% CI, –0.09 to 0.00; P =.041) at follow-up, but there were no differences in generic QoL, dyspnea scores, or the ESWT. No adverse events occurred during the intervention. Interpretation: In patients with persistent dyspnea 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 dyspnea following PE. Further research is needed, however, to assess the optimal patient selection, timing, mode, and duration of rehabilitation. Clinical Trial Registration: ClinicalTrials.gov; No.: NCT03405480; URL: www.clinicaltrials.gov
AB - Background: Persistent dyspnea, functional limitations, and reduced quality of life (QoL) are common following pulmonary embolism (PE). Rehabilitation is a potential treatment option, but the scientific evidence is limited. Research Question: Does an exercise-based rehabilitation program improve exercise capacity in PE survivors with persistent dyspnea? Study Design and Methods: This randomized controlled trial was conducted at two hospitals. Patients with persistent dyspnea following PE diagnosed 6 to 72 months earlier, without cardiopulmonary comorbidities, were randomized 1:1 to either the rehabilitation or the control group. The rehabilitation program consisted of two weekly sessions of physical exercise for 8 weeks and one educational session. The control group received usual care. The primary end point was the difference in Incremental Shuttle Walk Test between groups at follow-up. Secondary end points included differences in the Endurance Shuttle Walk Test (ESWT), QoL (EQ-5D and Pulmonary Embolism-QoL questionnaires) and dyspnea (Shortness of Breath questionnaire). Results: A total of 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 m; 95% CI, 17.7-88.3; P =.0035). The rehabilitation group reported better scores on the Pulmonary Embolism-QoL questionnaire (mean difference, –4%; 95% CI, –0.09 to 0.00; P =.041) at follow-up, but there were no differences in generic QoL, dyspnea scores, or the ESWT. No adverse events occurred during the intervention. Interpretation: In patients with persistent dyspnea 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 dyspnea following PE. Further research is needed, however, to assess the optimal patient selection, timing, mode, and duration of rehabilitation. Clinical Trial Registration: ClinicalTrials.gov; No.: NCT03405480; URL: www.clinicaltrials.gov
KW - dyspnea
KW - exercise training
KW - pulmonary embolism
KW - quality of life
KW - rehabilitation
U2 - 10.1016/j.chest.2023.04.042
DO - 10.1016/j.chest.2023.04.042
M3 - Article
SN - 1931-3543
VL - 164
SP - 981
EP - 991
JO - Chest
JF - Chest
IS - 4
ER -