Studies have taken place all over the world that aim to show the effects of adding exercise training to drug therapy in the treatment of pulmonary arterial hypertension. They include this one, by the Scottish Pulmonary Vascular Team at the Golden Jubilee National Hospital, who delivered the first UK PH-specific exercise training programme (part-funded by the PHA UK).
The pulmonary rehabilitation programme ran with 30 patients for just over two years.
Exercise training was delivered by specialist physiotherapist Joanna Ford, who individually tailored the regime for every patient. The regime consisted of walking, cycling on a stationary bicycle, strength training, relaxation and respiratory muscle training. The exercises were often performed with supplementary oxygen and interval-training methods, both aim to maximise the training effect whilst minimising the strain on the heart. Patients were issued with equipment for home, including light weights, a stationary exercise bicycle and a pulse oximeter. They were then remotely monitored by the physiotherapist for twelve weeks.
Each participant was medically assessed at the beginning of the programme, after the three-week residential phase, then again after the 12-week home training period. A variety of clinical and physiological parameters were measured, including quality of life questionnaires, and six-minute walk distances, lung function tests and a cardiopulmonary exercise bike test were repeated at each interval.
The results demonstrated that supervised exercise training is safe and significantly improves exercise capacity, quality of life and breathing function in Scottish patients with PH.
This study was inspired by pioneering work performed over the last 15 years in Heidelberg, Germany, which has also delivered strong evidence that exercise in PH is both safe and beneficial when conducted under specialist supervision.