Long‐Term Effect of an Exercise Training Program on Physical Functioning and Quality of Life in Pulmonary Hypertension: A Randomized Controlled Trial

The aim of this study was to evaluate the effects of a 6‐month combined aerobic and strength exercise training program on functional and psychological aspects and health‐related quality of life in patients with PH and to evaluate its longer‐term impact. In total, 22 stable patients (mean age 53.9 ± 13.8, 13 female) with pulmonary hypertension of World Health Organization (WHO) class I‐III participated in a nine‐month study. They were randomly assigned into two groups: Group A participated in a 6‐month combined aerobic and strength exercise training program, whereas Group B remained untrained. All patients underwent physical and psychological assessment at baseline and at month 6 (after completing the exercise program) and physical assessment after 9 months (3 months posttraining). After the 6‐month exercise training program, patients of Group A significantly improved their physical (6MWD, STS 10 rep, STS 20 rep, TUG, lower limb strength, cardiopulmonary exercise time, METs, peak VO 2 , VCO 2 , and VE/VCO 2 slope) and psychological aspects (SF‐36, STAI, and BDI). Between the two groups, differences were observed at the 6MWD (95% CI: 36.2‐64.6, η 2 = 0.72), STS 10 rep (95% CI: 6.6‐2.2, η 2 = 0.4), STS 20 rep (95% CI: 10.8‐2.4, η 2 = 0.34), lower limb strength (95% CI: 7.2‐3.6, η 2 = 0.38), cardiopulmonary exercise time (95% CI: 0.1‐3.3, η 2 = 0.2), and VCO 2 (95% CI: 0.1‐0.5, η 2 = 0.2). Additionally, psychological changes were noted at SF‐36, PCS (95% CI: 3.6‐14.8, η 2 = 0.35), MCS (95% CI: 1.3‐16.1, η 2 = 0.22), TCS (95% CI: 1.3‐16.1, η 2 = 0.22), and STAI (95% CI: 1.8‐28.2, η 2 = 0.18). The favorable results of exercise were maintained at the 3‐month posttraining follow‐up assessment. No exercise‐induced complications were observed throughout the study. In conclusion, a long‐term exercise training program is a safe and effective intervention to improve functional status, psychological aspects, and health‐related quality of life in patients with PH.