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Original Research: Pulmonary Vascular Disease |

Benefits of Intensive Treadmill Exercise Training on Cardiorespiratory Function and Quality of Life in Patients With Pulmonary HypertensionExercise Training in Pulmonary Hypertension

Leighton Chan, MD, MPH; Lisa M. K. Chin, PhD; Michelle Kennedy, MS; Joshua G. Woolstenhulme, DPT; Steven D. Nathan, MD, FCCP; Ali A. Weinstein, PhD; Gerilynn Connors, BS; Nargues A. Weir, MD, FCCP; Bart Drinkard, MSPT; James Lamberti, MD, FCCP; Randall E. Keyser, PhD
Author and Funding Information

From the Rehabilitation Medicine Department (Drs Chan, Chin, Woolstenhulme, and Keyser; Ms Kennedy; and Mr Drinkard) National Institutes of Health, Bethesda, MD; Department of Rehabilitation Science (Drs Woolstenhulme, Weinstein, and Keyser), George Mason University, Fairfax, VA; Department of Medicine (Drs Nathan, Weir, and Lamberti), Pulmonary Rehabilitation Center (Ms Connors), Inova Fairfax Hospital, Falls Church, VA.

Correspondence to: Leighton Chan, MD, MPH, Rehabilitation Medicine Department, Clinical Center, Bldg 10, National Institutes of Health, Room 1-1469, 10 Center Dr, MSC 1604, Bethesda, MD 20892-1604; e-mail: chanle@cc.nih.gov


Funding/Support: This work was supported by the US National Institutes of Health [Intramural Funds 1 Z01 CL060068-05 CC].

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(2):333-343. doi:10.1378/chest.12-0993
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Background:  Pulmonary hypertension (PH) restricts the ability to engage in physical activity and decreases longevity. We examined the impact of aerobic exercise training on function and quality of life in patients with World Health Organization group 1 PH.

Methods:  Patients were randomized to a 10-week education only (EDU) or education/exercise combined (EXE) group. The exercise program consisted of 24-30 sessions of treadmill walking for 30-45 min per session at 70% to 80% of heart rate reserve. Outcome variables included changes in 6-min walk test (6MWT) distance, time to exercise intolerance, peak work rate (WR) from a cardiopulmonary treadmill test, and quality-of-life measures, including the Short Form Health Survey, version 2 (SF-36v2) and Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR).

Results:  Data are presented as mean ± SD. Twenty-three women (age, 54 ± 11 years; BMI, 31 ± 7 kg/m2) were randomized to the EDU (n = 13) or EXE (n = 10) groups. Following 10 weeks of intervention, patients in the EXE group demonstrated an improvement in 6MWT distance (56 ± 45 m; P = .002), increased time to exercise intolerance (1.9 ± 1.3 min; P = .001), and peak WR (26 ± 23 W; P = .004). Additionally, the EXE group scored significantly (P < .050) better on six of the eight scales on SF-36v2, and five of the six scales on CAMPHOR. In contrast, no significant improvement was observed for any of the outcome measures following EDU. No adverse events were noted in either group.

Conclusion:  Ten weeks of brisk treadmill walking improved 6MWT distance, cardiorespiratory function, and patient-reported quality of life in female patients with group 1 PH.

Trial registry:  ClinicalTrials.gov; No.: NCT00678821; URL: clinicaltrials.gov

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