Keen Carol, Hashmi-Greenwood Molly, York Janelle, Armstrong Iain J, Sage Karen, Kiely David
Pulmonary Vascular Diseases Unit, Sheffield teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Sheffield Hallam University, Sheffield, UK.
Pulm Circ. 2019 Nov 5;9(4):2045894019885356. doi: 10.1177/2045894019885356. eCollection 2019 Oct-Dec.
Highly structured, supervised exercise training has been shown to be beneficial in patients with pulmonary hypertension. Despite evidence of the effectiveness of community-based rehabilitation in other cardiopulmonary diseases, there are limited data in patients with pulmonary hypertension.
This prospective study evaluated the intervention of a physiotherapist well-being review in patients with pulmonary hypertension who had been established on targeted drug therapy for between 3 and 12 months. The intervention included a detailed consultation assessing functional, social and motivational status to identify individual patient rehabilitation goals and facilitate tailored referrals to community-based services.
One hundred and thirty-eight patients (79% pulmonary arterial hypertension, 17% chronic thromboembolic disease), age 67 ± 14 years, diagnosed over a one year period were evaluated between July 2017 and January 2018. Fifty-two per cent of patients were referred to community-based pulmonary rehabilitation programmes, 19% received other forms of community rehabilitation, 17% were given exercise advice, 5% had an assessment of social support and 7% declined any intervention. At the end of the study, 32% of patients were undertaking independent exercise.
This study has identified that the majority of patients with pulmonary hypertension who are optimised on targeted drug therapy have rehabilitation needs. The use of a physiotherapy well-being review can identify this need and facilitate access to community-based rehabilitation. Further research is required to evaluate the efficacy of such interventions in pulmonary hypertension.
高度结构化的监督性运动训练已被证明对肺动脉高压患者有益。尽管有证据表明社区康复对其他心肺疾病有效，但关于肺动脉高压患者的数据有限。
这项前瞻性研究评估了对已接受靶向药物治疗3至12个月的肺动脉高压患者进行物理治疗师健康状况评估的干预措施。该干预包括详细咨询，评估功能、社会和动机状况，以确定个体患者的康复目标，并促进向社区服务机构进行有针对性的转诊。
在2017年7月至2018年1月期间，对138例患者（79%为肺动脉高压，17%为慢性血栓栓塞性疾病）进行了评估，这些患者年龄为67±14岁，在一年时间内被诊断出来。52%的患者被转诊至社区肺康复项目，19%接受了其他形式的社区康复，17%得到了运动建议，5%接受了社会支持评估，7%拒绝了任何干预。在研究结束时，32%的患者进行独立运动。
本研究表明，大多数在靶向药物治疗下病情稳定的肺动脉高压患者有康复需求。通过物理治疗师健康状况评估可以识别这种需求，并促进患者获得社区康复服务。需要进一步研究来评估此类干预措施在肺动脉高压中的疗效。
