Exercise in pulmonary hypertension

Background: Pulmonary hypertension (PH) is a disorder characterized by elevation in mean pulmonary arterial pressure of 25 mmHg or greater at rest or 30 mmHg during exercise. Due to the complex clinical presentation and poor prognosis of PH, exercise or increased physical exertion was thought to be detrimental and hence not recommended in these patients. Although physiotherapists may be required to consider exercise prescription for patients with PH, the safety of exercise for these patients remains unclear.Objective: To describe the evidence regarding effectiveness and safety of exercise training in patients with PH.Results: A total of seven studies which evaluated the effect of exercise training in patients with idiopathic and secondary PH were identified for review. The majority of studies found that sub-maximal exercise training enhanced patients’ exercise capacity and improved their health-related quality of life. Most importantly, none of the studies reported any adverse effects during or after exercise training.Conclusion: Sub-maximal exercise training may have beneficial effects in patients with PH. Therefore, participation in an exercise program and/or supervised rehabilitation program should be encouraged for patients with stable PH.