Benefits of intensive treadmill exercise training on cardiorespiratory function and quality of life in patients with pulmonary hypertension

Abstract

Background: Pulmonary hypertension (PH) restricts the ability to engage in physical activity and decreases longevity. We examined the impact of aerobic exercise training on function and quality of life in patients with World Health Organization group 1 PH.

Methods: Patients were randomized to a 10-week education only (EDU) or education/exercise combined (EXE) group. The exercise program consisted of 24-30 sessions of treadmill walking for 30-45 min per session at 70% to 80% of heart rate reserve. Outcome variables included changes in 6-min walk test (6MWT) distance, time to exercise intolerance, peak work rate (WR) from a cardiopulmonary treadmill test, and quality-of-life measures, including the Short Form Health Survey, version 2 (SF-36v2) and Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR).

Results: Data are presented as mean SD. Twenty-three women (age, 54 11 years; BMI, 31 7 kg/m 2 ) were randomized to the EDU (n 5 13) or EXE (n 5 10) groups. Following 10 weeks of intervention, patients in the EXE group demonstrated an improvement in 6MWT distance (56 45 m; P 5 .002), increased time to exercise intolerance (1.9 1.3 min; P 5 .001), and peak WR (26 23 W; P 5 .004). Additionally, the EXE group scored significantly ( P , .050) better on six of the eight scales on SF-36v2, and fi ve of the six scales on CAMPHOR. In contrast, no significant improvement was observed for any of the outcome measures following EDU. No adverse events were noted in either group.

Conclusion: Ten weeks of brisk treadmill walking improved 6MWT distance, cardiorespiratory function, and patient-reported quality of life in female patients with group 1 PH.

Trial registration: ClinicalTrials.gov NCT00678821.

Figure 1.

Participant flow through the stages of the randomized trial.

Figure 2.

Distribution of the improvement observed in the 6MWT distance for both groups. Black bars represent patients in the education/exercise combined (EXE) group and gray bars represent patients in the education only (EDU) group. Dashed black line represents the minimally important difference for 6MWT distance in patients with pulmonary hypertension. 6MWT = 6-min walk test.

Figure 3.

Health-related quality-of-life scores (SF-36v2 and CAMPHOR) for patients in the EXE group (left side) and EDU group (right side). White bars represent preintervention scores and black bars represent postintervention scores. Upright triangle symbols represent scores of SF-36v2 for the United States population. P values are given for all domains and * denotes significant difference (P < .05) from preintervention scores. CAMPHOR = Cambridge Pulmonary Hypertension Outcome Review; Gen Health = general health; Phys Func = physical functioning; SF-36v2 = Short Form 36 Health Survey, version 2; Social Func = social functioning. See Figure 2 legend for expansion of other abbreviations.