Haukeland-Parker Stacey, Jervan Øyvind, Ghanima Waleed, Spruit Martijn A, Holst René, Gleditsch Jostein, Tavoly Mazdak, Stavem Knut, Steine Kjetil, Atar Dan, Dahm Anders Erik Astrup, Klok Frederikus A, Johannessen Hege Hølmo
Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Res Pract Thromb Haemost. 2025 Mar 19;9(2):102736. doi: 10.1016/j.rpth.2025.102736. eCollection 2025 Feb.
Exercise is safe and effective in the short-term following pulmonary embolism. To date, little is known about the long-term effects.
The aim of the study was to investigate whether the effects of exercise-based rehabilitation are maintained 6 months after completion in patients with persistent dyspnea following pulmonary embolism when compared with usual care.
A 2-center, randomized controlled trial compared 8 weeks of exercise-based rehabilitation with usual care. Patients were reassessed postintervention and 6 months later. Exercise capacity was measured with the incremental shuttle walk test (ISWT). Dyspnea was assessed with the Shortness of Breath Questionnaire, and health-related quality of life was assessed with disease-specific (Pulmonary Embolism Quality of Life Questionnaire) and generic questionnaires.
In total, 159 of 211 randomized patients attended follow-up 6 months postintervention. The significant improvement on the ISWT in the rehabilitation group was maintained at the 6-month follow-up (96 m; SE: 15 m; 95% CI: 66, 127). There were no changes on the ISWT in the control group at either time point. From postintervention to 6×-month follow-up, the rehabilitation group had further improvements in dyspnea compared with the control group (-3 points; SE: 1.4; 95% CI: -6, -1; = .02). Health-related quality of life improved in both groups although superior improvements were seen in the rehabilitation group.
The improvement in exercise capacity after 8 weeks of exercise-based rehabilitation in patients with pulmonary embolism and persistent dyspnea was maintained at the 6-month follow-up, while no improvement was observed in the control group, highlighting the relevance of offering rehabilitation to these patients.
肺栓塞后的短期内，运动是安全且有效的。迄今为止，人们对其长期影响知之甚少。
本研究旨在调查与常规护理相比，肺栓塞后持续呼吸困难的患者在完成基于运动的康复治疗6个月后，其康复效果是否得以维持。
一项2中心随机对照试验，将8周的基于运动的康复治疗与常规护理进行比较。在干预后及6个月后对患者进行重新评估。采用递增往返步行试验（ISWT）测量运动能力。用气短问卷评估呼吸困难情况，并用疾病特异性问卷（肺栓塞生活质量问卷）和通用问卷评估健康相关生活质量。
211例随机分组患者中，共有159例在干预后6个月接受了随访。康复组在ISWT上的显著改善在6个月随访时得以维持（96米；标准误：15米；95%置信区间：66, 127）。对照组在两个时间点的ISWT均无变化。从干预后到6个月随访，与对照组相比，康复组的呼吸困难情况有进一步改善（-3分；标准误：1.4；95%置信区间：-6, -1；P = .02）。两组的健康相关生活质量均有所改善，不过康复组的改善更为明显。
肺栓塞且持续呼吸困难的患者在接受8周基于运动的康复治疗后，运动能力的改善在6个月随访时得以维持，而对照组未观察到改善，这凸显了为这些患者提供康复治疗的重要性。
