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[Chest发表论文]:肺动脉栓塞后持续呼吸困难患者运动锻炼的效果
2023年11月16日 时讯速递, 进展交流 [Chest发表论文]:肺动脉栓塞后持续呼吸困难患者运动锻炼的效果已关闭评论

PULMONARY VASCULAR: ORIGINAL RESEARCH| VOLUME 164, ISSUE 4, P981-991

The Effects of Exercise Training in Patients With Persistent Dyspnea Following Pulmonary Embolism: A Randomized Controlled Trial

Øyvind Jervan, Stacey Haukeland-Parker, Jostein Gleditsch, et al

Chest 2023; 164: 981-991 Open Access Published: May 04, 2023 DOI:https://doi.org/10.1016/j.chest.2023.04.042

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

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