Principles of Rehabilitation and Reactivation: Pulmonary Hypertension

Most recently, a specialized and carefully monitored exercise training and rehabilitation program has been recommended as add-on to medical treatment in patients with pulmonary arterial hypertension (class I, level of evidence A). Three prospective randomized, controlled trials, 10 prospective uncontrolled trials, 2 retrospective studies and 2 case series in more than 470 patients with severe pulmonary hypertension (PH) and right heart failure reported beneficial effects of a specialized exercise training and rehabilitation program, i.e. significant improvement in symptoms, exercise capacity, cardiorespiratory function and quality of life, compared with untrained controls. All training studies reported an acceptable safety profile, and some uncontrolled studies showed excellent 1and 2-year survival rates. However, most studies had a quite small sample size (ranging from 2 to 183 patients) and an uncontrolled design, and they were not dePublished online: February 13, 2015 Nicola Ehlken, BSc Pulmonary Hypertension Center, Thorax Clinic University of Heidelberg, Amalienstrasse 5 DE–69126 Heidelberg (Germany) E-Mail Nicola.ehlken @ med.uni-heidelberg.de © 2015 S. Karger AG, Basel 0025–7931/15/0894–0265$39.50/0 www.karger.com/res Previous articles in this series: 1. Osadnik CR, Rodrigues FMM, Camillo CA, Loeckx M, Janssens W, Dooms C, Troosters T: Principles of rehabilitation and reactivation. Respiration 2015;89:2–11. 2. Holland AE, Dowman LM, Hill CJ: Principles of rehabilitation and reactivation: interstitial lung disease, sarcoidosis and rheumatoid disease with respiratory involvement. Respiration 2015;89:89–99. 3. Burtin C, Hebestreit H: Rehabilitation in patients with chronic respiratory disease other than chronic obstructive pulmonary disease: exercise and physical activity interventions in cystic fibrosis and non-cystic fibrosis bronchiectasis. Respiration DOI: 10.1159/000375170. D ow nl oa de d by : 54 .1 91 .4 0. 80 9 /1 7/ 20 17 4 :0 0: 08 A M