Faculty of Rehabilitation, Riga Stradins University, LV-1007 Riga, Latvia.
Department of Rehabilitation, Pauls Stradins Clinical University Hospital, LV-1012 Riga, Latvia.
Medicina (Kaunas). 2022 May 14;58(5):662. doi: 10.3390/medicina58050662.
Pulmonary arterial hypertension (PAH) is a rare, chronic, progressive, and life-threatening disease; however, the appropriate target medical treatment today allows patients with PAH not only to survive but also to live a relatively normal life. However, patients face the challenge of adapting and maintaining a good quality of life, thus it is important to consider complex interventions related not only to medical treatment. This was a prospective, randomized, controlled, single-blind study. Twenty-one (21) patients diagnosed with PAH were included and randomly assigned to training or control group. All participants continued target medical therapy. Furthermore, TG underwent the individually tailored 12-week remote physiotherapy program. As a primary outcome measurement, the Impact on Participation and Autonomy Questionnaire (IPA) was used. Secondary outcome included aerobic capacity (6MWT), accelerometery and general self-efficacy (GSE). Data were collected at baseline, after 12 weeks and at follow-up 6 months after the beginning of the intervention. A significant difference between the groups was found in the follow-up assessment on three of the four IPA subscales analyzed, AO, RF, and AI. The total IPA score decreased significantly in TG after the program, indicating an improved participation. In addition, in TG a significant increase in 6MWT results, daily time in low- or moderate-intensity physical activities, and GSE was observed. In summary, the individually tailored physiotherapy program investigated added to stable target medical therapy in patients with PAH encourages improvement and prevents possible deterioration of perceived participation of patients in activities of their everyday life in the context of one's health condition in the long term, along with improved exercise capacity and increased time spent in low- or moderate-intensity physical activities. Future studies are needed to develop and evaluate long-term intervention to support patients living with this rare, chronic, and life-threatening disease.
肺动脉高压（PAH）是一种罕见的、慢性的、进行性的、危及生命的疾病；然而，如今适当的靶向药物治疗不仅使 PAH 患者能够存活，而且还能相对正常地生活。然而，患者面临着适应和保持良好生活质量的挑战，因此，考虑与医疗治疗相关的复杂干预措施非常重要。这是一项前瞻性、随机、对照、单盲研究。共纳入 21 例 PAH 患者，并随机分为训练组和对照组。所有参与者继续接受靶向药物治疗。此外，TG 还接受了个体化的为期 12 周的远程物理治疗方案。以参与和自主影响问卷（IPA）作为主要评估指标。次要结果包括有氧运动能力（6MWT）、加速度计和一般自我效能感（GSE）。数据在基线、12 周后和干预开始后 6 个月进行收集。在随访评估中，发现 IPA 的四个亚量表中有三个存在组间差异，即 AO、RF 和 AI。在方案实施后，TG 的 IPA 总分显著下降，表明参与度提高。此外，在 TG 中，6MWT 结果、日常低或中强度体力活动时间和 GSE 均显著增加。总之，个体化的物理治疗方案在 PAH 患者中与稳定的靶向药物治疗相结合，鼓励患者在长期内改善和预防其日常生活活动感知参与度的可能恶化，同时提高运动能力并增加低或中强度体力活动的时间。需要进一步开展未来研究以开发和评估长期干预措施，以支持患有这种罕见、慢性和危及生命的疾病的患者。
