Long-Term Effect of an Exercise Training Program on Physical Functioning and Quality of Life in Pulmonary Hypertension: A Randomized Controlled Trial

The aim of this study was to evaluate the effects of a 6-month combined aerobic and strength exercise training program on functional and psychological aspects and health-related quality of life in patients with PH and to evaluate its longer-term impact. In total, 22 stable patients (mean age 53.9 +/- 13.8, 13 female) with pulmonary hypertension of World Health Organization (WHO) class I-III participated in a nine-month study. They were randomly assigned into two groups: Group A participated in a 6-month combined aerobic and strength exercise training program, whereas Group B remained untrained. All patients underwent physical and psychological assessment at baseline and at month 6 (after completing the exercise program) and physical assessment after 9 months (3 months posttraining). After the 6-month exercise training program, patients of Group A significantly improved their physical (6MWD, STS 10 rep, STS 20 rep, TUG, lower limb strength, cardiopulmonary exercise time, METs, peak VO2, VCO2, and VE/VCO2 slope) and psychological aspects (SF-36, STAI, and BDI). Between the two groups, differences were observed at the 6MWD (95% CI: 36.2-64.6, eta(2)= 0.72), STS 10 rep (95% CI: 6.6-2.2, eta(2)= 0.4), STS 20 rep (95% CI: 10.8-2.4, eta(2) = 0.34), lower limb strength (95% CI: 7.2-3.6, eta(2) = 0.38), cardiopulmonary exercise time (95% CI: 0.1-3.3, eta(2) =0.2), and VCO2 (95% CI: 0.1-0.5, eta(2)= 0.2). Additionally, psychological changes were noted at SF-36, PCS (95% CI: 3.6-14.8, eta(2) = 0.35), MCS (95% CI: 1.3-16.1, eta(2)= 0.22), TCS (95% CI: 1.3-16.1, eta(2)= 0.22), and STAI (95% CI: 1.8-28.2, eta(2) 0.18). The favorable results of exercise were maintained at the 3-month posttraining follow-up assessment. No exercise-induced complications were observed throughout the study. In conclusion, a long-term exercise training program is a safe and effective intervention to improve functional status, psychological aspects, and health-related quality of life in patients with PH.