Individually tailored 12-week home-based exercise program improves both physical capacity and sleep quality in patients with pulmonary arterial hypertension

Abstract

Background: Most patients with optimal PAH-targeted medical therapy suffer from clinical symptoms, reduced exercise tolerance and have a poor quality of life. The 2019 European Respiratory Society task force statement on physical exercise and rehabilitation in patients with severe, chronic PH suggests that individually adjusted and monitored exercise programs are likely to be safe for PH patients, who are clinically stable on medical therapy. Currently, the development of PAH-specific rehabilitation interventions is still in the research stage. We present the preliminary results of a more extensive study with the aim to show the effectiveness of a 12-week individualized, home-based exercise program in promoting physical capacity, quality of sleep and reducing signs of emotional distress in patients with PAH. Methods: This was a prospective randomized controlled interventional study. 16 PAH patients were included in the analysis. Training group underwent a complex training program, consisting of 12-week individually tailored home-based exercise training, education, self-control measures and tele-rehabilitation components. The program included muscle strength training, respiratory, aerobic exercise and relaxation techniques. Results: A statistically significant mean increase in 6MWT distance was observed for the training group (Δ = 51.7 ± 45.1 m). In six participants (66.7%) from the training group and two patients (28.6%) from the control group, the minimal clinically significant difference for 6MWT distance was observed (25–33 m). IPsubmax test results changed significantly in training group (Δ = 9.8 ± 4.7 cm H20). PSQI values sleep quality improved from poor to good in four (44.5%) patients from training group. HADS sub-scales scores values confirmed clinically important reduction of anxiety symptoms in both groups. Depression symptoms did not show clinically important changes. No adverse events were observed. Conclusion: The studied 12-week individually tailored home-based exercise program is effective in stable PAH patients by improving physical functional capacity, as well as sleep quality. Further studies are required to solidify the methodology of exercise programmes in the field of PAH. These are the preliminary results of ongoing study.