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

Objectives of this European Respiratory Society 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 th...

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Main Authors: Grünig, Ekkehard (Author) , Eichstaedt, Christina (Author) , Benjamin, Nicola (Author)
Format: Article (Journal)
Language:English
Published: February 28, 2019
In: The European respiratory journal
Year: 2019, Volume: 53, Issue: 2
ISSN:1399-3003
DOI:10.1183/13993003.00332-2018
Online Access:Verlag, Volltext: https://doi.org/10.1183/13993003.00332-2018
Verlag, Volltext: https://erj.ersjournals.com/content/53/2/1800332
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Author Notes:Ekkehard Grünig, Christina Eichstaedt, Joan-Albert Barberà, Nicola Benjamin, Isabel Blanco, Eduardo Bossone, Antonio Cittadini, Gerry Coghlan, Paul Corris, Michele D'Alto, Antonello D'Andrea, Marion Delcroix, Frances de Man, Sean Gaine, Stefano Ghio, Simon Gibbs, Lina Gumbiene, Luke S. Howard, Martin Johnson, Elena Jurevičienė, David G. Kiely, Gabor Kovacs, Alison MacKenzie, Alberto M. Marra, Noel McCaffrey, Paul McCaughey, Robert Naeije, Horst Olschewski, Joanna Pepke-Zaba, Abílio Reis, Mário Santos, Stéphanie Saxer, Robert M. Tulloh, Silvia Ulrich, Anton Vonk Noordegraaf and Andrew J. Peacock

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520 |a Objectives of this European Respiratory Society 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 pathophysiological mechanisms. - In studies (784 PH patients in total, including six randomised controlled trials, three controlled trials, 10 prospective cohort studies and four 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 healthcare institutions, commissioners of healthcare and research funding institutions is greatly needed. There is a strong need to establish specialised rehabilitation programmes for PH patients to enhance patient access to this treatment intervention. 
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