Effects of combined aerobic, resistance and inspiratory training in patients with pulmonary hypertension: A systematic review.

Christos Kourek, Antonia Zachariou, Eleftherios Karatzanos, Michalis Antonopoulos, Theodora Soulele, Andreas Karabinis, Serafim Nanas, Stavros Dimopoulos
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Abstract

Background: Pulmonary hypertension (PH) is a serious progressive disorder of the modern world, characterized by endothelial dysfunction and impaired vasoreactivity. Patients with PH usually present exercise intolerance from the very early stages and reduced exercise capacity. Exercise training has been shown to have beneficial effects in patients with cardiovascular comorbidities. However, data regarding the effects of combined exercise training programs in patients with PH still remains limited.

Aim: To investigate the effects of combined exercise training programs on exercise capacity and quality of life in patients with PH.

Methods: Our search included all available randomized controlled trials (RCTs) regarding combined aerobic, resistance and inspiratory training programs in patients with PH in 4 databases (Pubmed, PEDro, Embase, CINAHL) from 2012 to 2022. Five RCTs were included in the final analysis. Functional capacity, assessed by peak VO2 or 6-min walking test (6MWT), as well as quality of life, assessed by the SF-36 questionnaire, were set as the primary outcomes in our study.

Results: Peak VO2 was measured in 4 out of the 5 RCTs while 6MWT was measured in all RCTs. Both indices of functional capacity were significantly increased in patients with PH who underwent combined exercise training compared to the controls in all of the included RCTs (P < 0.05). Quality of life was measured in 4 out of 5 RCTs. Although patients improved their quality of life in each group, however, only 2 RCTs demonstrated further improvement in patients performing combined training compared to controls.

Conclusion: By this systematic review, we have demonstrated that combined aerobic, resistance and inspiratory exercise training is safe and has beneficial effects on aerobic capacity and quality of life in patients with PH. Such exercise training regimen may be part of the therapeutic strategy of the syndrome.

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肺动脉高压患者进行有氧、阻力和吸气联合训练的效果:系统综述。
背景:肺动脉高压(PH)是现代社会一种严重的渐进性疾病,其特点是内皮功能障碍和血管活性受损。肺动脉高压患者通常在早期阶段就表现出运动不耐受和运动能力下降。运动训练已被证明对患有心血管并发症的患者有益。目的:研究综合运动训练计划对 PH 患者运动能力和生活质量的影响:我们的检索包括2012年至2022年期间4个数据库(Pubmed、PEDro、Embase、CINAHL)中所有关于PH患者联合有氧、阻力和吸气训练计划的随机对照试验(RCT)。最终分析纳入了五项研究。我们将通过峰值 VO2 或 6 分钟步行测试(6MWT)评估的功能能力以及通过 SF-36 问卷评估的生活质量作为研究的主要结果:结果:在 5 项研究中,有 4 项研究测量了峰值 VO2,而所有研究都测量了 6MWT 。在所有纳入的研究中,与对照组相比,接受联合运动训练的 PH 患者的这两项功能指数都有明显提高(P < 0.05)。5 项研究中的 4 项对生活质量进行了测量。虽然每组患者的生活质量都有所改善,但只有 2 项研究表明,与对照组相比,接受联合训练的患者的生活质量得到了进一步改善:通过此次系统回顾,我们证明了联合有氧、阻力和吸气运动训练是安全的,并对 PH 患者的有氧能力和生活质量产生有益影响。这种运动训练方案可作为该综合征治疗策略的一部分。
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