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

Abstract

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, η ² = 0.72), STS 10 rep (95% CI: 6.6-2.2, η ² = 0.4), STS 20 rep (95% CI: 10.8-2.4, η ² = 0.34), lower limb strength (95% CI: 7.2-3.6, η ² = 0.38), cardiopulmonary exercise time (95% CI: 0.1-3.3, η ² = 0.2), and VCO₂ (95% CI: 0.1-0.5, η ² = 0.2). Additionally, psychological changes were noted at SF-36, PCS (95% CI: 3.6-14.8, η ² = 0.35), MCS (95% CI: 1.3-16.1, η ² = 0.22), TCS (95% CI: 1.3-16.1, η ² = 0.22), and STAI (95% CI: 1.8-28.2, η 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.

Figure 1

CONSORT diagram of the study design.

Figure 2

Box plot presenting (a) peak VO₂, (b) VE/VCO₂ slope, and (c) 6-minute walk distance of exercised patients at baseline, exercise training period, and posttraining follow-up.