Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petach Tiqwa, Israel.
J Card Fail. 2011 Mar;17(3):196-200. doi: 10.1016/j.cardfail.2010.10.004. Epub 2010 Dec 3.
Rehabilitation is a central treatment modality for patients with chronic cardiopulmonary disease. Physical exertion for patients with pulmonary arterial hypertension (PAH) has typically been discouraged. Inpatient pulmonary rehabilitation has been shown to improve exercise capacity in patients with PAH. The present study aimed to evaluate outpatient pulmonary rehabilitation for patients with PAH.
Twenty-two patients with PAH or chronic pulmonary thromboembolic disease were allocated to ambulatory rehabilitation (n = 11) or to the control group (n = 11). All patients were stable on PAH-specific medication. The rehabilitation group underwent 24 1-hour sessions of exercise training/rehabilitation over 12 weeks. Primary end points were change in 6-minute walking distance (6MWD) and peak oxygen uptake (VO(2)) on cardiopulmonary exercise testing. All of the patients assigned to rehabilitation and 9 control subjects completed the study. In the rehabilitation group, 6MWD increased by 32 m, and in the control group 6MWD decreased by 26 meters (P = .003). Peak VO(2) increased in the rehabilitation group by 1.1 mL kg(-1) min(-1) and decreased by 0.5 mL kg(-1) min(-1) in the control group (P < .05). Peak work rate during cardiopulmonary exercise test also increased in the rehabilitation group, with borderline significance (P = .051). Echocardiography and blood N-terminal pro-brain natriuretic peptide levels were unchanged. No adverse events occurred due to the rehabilitation program.
Ambulatory rehabilitation is a safe and efficacious treatment for patients with pulmonary hypertension already on medical therapy.
clinicaltrials.gov ID: NCT00544726.
康复是慢性心肺疾病患者的主要治疗手段。通常不鼓励肺动脉高压（PAH）患者进行体力活动。住院肺康复已被证明可改善 PAH 患者的运动能力。本研究旨在评估 PAH 患者的门诊肺康复。
22 例 PAH 或慢性肺血栓栓塞性疾病患者被分配至门诊康复组（n = 11）或对照组（n = 11）。所有患者均接受 PAH 特异性药物治疗。康复组在 12 周内接受了 24 次 1 小时的运动训练/康复。主要终点是 6 分钟步行距离（6MWD）和心肺运动试验时峰值摄氧量（VO 2）的变化。所有分配到康复组的患者和 9 名对照组患者均完成了研究。在康复组，6MWD 增加了 32 米，而对照组则减少了 26 米（P =.003）。康复组 VO 2 峰值增加了 1.1 mL kg(-1) min(-1)，对照组则减少了 0.5 mL kg(-1) min(-1)（P <.05）。心肺运动试验时的峰值工作率也在康复组中增加，具有边缘显著性（P =.051）。超声心动图和血液 N-末端脑利钠肽水平无变化。康复计划没有导致任何不良反应。
对于已经接受药物治疗的肺动脉高压患者，门诊康复是一种安全有效的治疗方法。
clinicaltrials.gov ID：NCT00544726。
