Exercise capacity, dyspnea, and quality of life 6 months after exercise-based rehabilitation in patients with persistent dyspnea following pulmonary embolism

Abstract

Background: Exercise is safe and effective in the short-term following pulmonary embolism. To date, little is known about the long-term effects.

Objectives: The aim of the study was to investigate whether the effects of exercise based rehabilitation are maintained 6 months after completion in patients persistent dyspnea following pulmonary embolism when compared with usual care.

Methods: A 2-center, randomized controlled trial compared 8 weeks of exercise-based rehabilitation with usual care. Patients were reassessed postintervention and 6 months later. Exercise capacity was measured with the incremental shuttle walk test (ISWT). Dyspnea was assessed with the Shortness of Breath Questionnaire, and health-related quality of life was assessed with disease-specific (Pulmonary Embolism Quality of Questionnaire) and generic questionnaires. Results: In total, 159 of 211 randomized patients attended follow-up 6 months post intervention. The significant improvement on the ISWT in the rehabilitation group maintained at the 6-month follow-up (96 m; SE: 15 m; 95% CI: 66, 127). There were changes on the ISWT in the control group at either time point. From postintervention to 6x-month follow-up, the rehabilitation group had further improvements in dyspnea compared with the control group (-3 points; SE: 1.4; 95% CI: -6, -1; P = .02). Health related quality of life improved in both groups although superior improvements were seen in the rehabilitation group. Conclusion: The improvement in exercise capacity after 8 weeks of exercise-based rehabilitation in patients with pulmonary embolism and persistent dyspnea maintained at the 6-month follow-up, while no improvement was observed in control group, highlighting the relevance of offering rehabilitation to these patients.