Plain language summary Exercise‐based rehabilitation in pulmonary hypertension Key messages In people with pulmonary hypertension who are medically stable, exercise‐based rehabilitation is most likely to be safe and improve quality of life. The evidence suggests that exercise‐based rehabilitation may result in a large increase in exercise capacity and a reduction in mean pulmonary arterial pressure. What is pulmonary hypertension? Pulmonary hypertension is a condition in which the blood pressure in the arteries that carry blood from the heart to the lungs is elevated well above normal. Often with a gradual onset, it affects people of all ages, reduces their quality of life and results in premature death. Exercise‐based rehabilitation is recommended for other chronic lung and heart disease populations; however up until recently, exercise was not recommended for pulmonary hypertension. What did we want to find out? We wanted to review the evidence from well‐designed clinical trials that compared exercise‐based rehabilitation with usual care. What did we do? We searched medical databases for clinical trials comparing exercise training versus usual care in people with PH to see if exercise improved short‐ and long‐term outcomes such as exercise capacity, health‐related quality of life, serious side effects and changes in the pressure in the pulmonary circulation. The updated review included 14 studies with 574 people, and we included data from 11 studies in analyses (462 participants). What did we find? The studies reported that exercise‐based rehabilitation may result in large increases in exercise capacity as evaluated by how far people could walk in six minutes and maximal oxygen consumption using a specialised exercise test; however, there was marked variability in this response. Health‐related quality of life was also most likely to be improved and exercise‐based rehabilitation may also result in a large reduction in the pressure in the pulmonary circulation. Serious side effects were rare and exercise‐based rehabilitation was unlikely to increase the risk of them. What are the limitations of the evidence? The evidence from these trials was of low to moderate quality. The main limitations in the studies was a lack of allocation concealment (participants knew whether they were in the exercise group or not, which could cause bias) and studies did not report the results of all the outcome data. In addition, some outcomes, for example exercise capacity, had a variable response, which we could not explain by examining different subgroups of people. How up to date is this evidence? The evidence is current to 28 June 2022.
【저자키워드】 Adult, exercise, bias, humans, male, female, Quality of life, Aged, Exercise therapy, Hypertension, pulmonary, Middle aged, Exercise Therapy/adverse effects,