ERS statement on exercise training and rehabilitation in patients with severe chronic pulmonary hypertension

Abstract

Objectives of this ERS Task Force were to summarise current studies, to develop strategies for future research and to increase availability and awareness of exercise training for pulmonary hypertension (PH) patients. An evidence-based approach with clinical expertise of the Task Force members, based on both literature search and face-to-face meetings was conducted. The statement summarises current knowledge and open questions regarding clinical effects of exercise training in PH, training modalities, implementation strategies and pathophysiologic mechanisms. In studies with 784 PH patients in total, including 6 randomised controlled trials, 3 controlled trials, 10 prospective cohort studies, and 4 meta-analyses exercise training has been shown to improve exercise capacity, muscular function, quality of life and possibly right ventricular function and pulmonary haemodynamics. Nevertheless, further studies are needed to confirm these data, to investigate the impact on risk profiles and to identify the most advantageous training methodology and underlying pathophysiological mechanisms. As exercise training appears to be effective, cost-efficient and safe, but is scarcely reimbursed, support from health care institutions, commissioners of health care and research funding institutions are of high need. There is a strong need to establish specialised rehabilitation programmes for PH patients to enhance patient access to this treatment intervention.