肺栓塞后持续性呼吸困难患者运动康复后6个月的运动能力、呼吸困难和生活质量

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis Pub Date : 2025-02-01 DOI:10.1016/j.rpth.2025.102736

Stacey Haukeland-Parker , Øyvind Jervan , Waleed Ghanima , Martijn A. Spruit , René Holst , Jostein Gleditsch , Mazdak Tavoly , Knut Stavem , Kjetil Steine , Dan Atar , Anders Erik Astrup Dahm , Frederikus A. Klok , Hege Hølmo Johannessen

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引用次数: 0

摘要

背景：肺栓塞后短期内运动是安全有效的。迄今为止，人们对其长期影响知之甚少。目的：研究以运动为基础的康复治疗在肺栓塞后持续呼吸困难患者完成治疗6个月后，与常规治疗相比，其效果能否维持。方法采用2个中心随机对照试验，将8周的运动康复与常规护理进行比较。干预后和6个月后对患者进行重新评估。运动能力测量采用增量穿梭行走试验（ISWT）。使用呼吸短促问卷评估呼吸困难，使用疾病特异性（肺栓塞生活质量问卷）和通用问卷评估与健康相关的生活质量。结果211例随机分组患者中有159例在干预后6个月参加了随访。康复组的ISWT在随访6个月时保持显著改善(96 m；SE: 15 m；95% ci: 66,127)。对照组在两个时间点的ISWT均无变化。从干预后到6×-month随访，康复组呼吸困难较对照组有进一步改善(−3分；SE: 1.4;95% ci:−6,−1；P = .02)。两组的健康相关生活质量均有改善，但康复组的改善更明显。结论肺栓塞伴持续性呼吸困难患者经过8周的运动康复后，运动能力的改善在6个月的随访中得以维持，而对照组未见改善，突出了对这些患者进行康复治疗的相关性。

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

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 with 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 Life Questionnaire) and generic questionnaires.

Results

In total, 159 of 211 randomized patients attended follow-up 6 months postintervention. The significant improvement on the ISWT in the rehabilitation group was maintained at the 6-month follow-up (96 m; SE: 15 m; 95% CI: 66, 127). There were no changes on the ISWT in the control group at either time point. From postintervention to 6×-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 was maintained at the 6-month follow-up, while no improvement was observed in the control group, highlighting the relevance of offering rehabilitation to these patients.

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