Kourek C, Zachariou A, Karatzanos E, Antonopoulos M, Soulele T, Karabinis A, Nanas S, Dimopoulos S. Effects of combined aerobic, resistance and inspiratory training in patients with pulmonary hypertension: A systematic review. World J Crit Care Med 2024; 13(2): 92585 [PMID: 38855278 DOI: 10.5492/wjccm.v13.i2.92585]
Corresponding Author of This Article
Stavros Dimopoulos, PhD, Director, Department of Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, 45-47 Ipsilantou Street, Athens 10676, Greece. stdimop@gmail.com
Research Domain of This Article
Rehabilitation
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Christos Kourek, Antonia Zachariou, Eleftherios Karatzanos, Michalis Antonopoulos, Stavros Dimopoulos, Department of Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens 10676, Greece
Christos Kourek, Department of Cardiology, 417 Army Share Fund Hospital of Athens, Athens 11521, Greece
Michalis Antonopoulos, Cardiac Surgery ICU, Onassis Cardiac Surgery center, Athens 17674, Attica, Greece
Theodora Soulele, Stavros Dimopoulos, Cardiac Surgery ICU, Onassis Cardiac Surgery Center, Athens 17674, Greece
Andreas Karabinis, Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens 17674, Greece
Serafim Nanas, Department of Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, National and Kapodistrian University of Athens, Athens 10676, Greece
Author contributions: Dimopoulos S designed the research; Kourek C and Zachariou A performed the research; Kourek C, Zachariou A, Karatzanos E, Antonopoulos M, Soulele T, Karabinis A, Nanas S and Dimopoulos S analyzed the data; Kourek C and Dimopoulos S wrote the paper; All authors revised the paper.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stavros Dimopoulos, PhD, Director, Department of Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Department of Critical Care Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, 45-47 Ipsilantou Street, Athens 10676, Greece. stdimop@gmail.com
Received: January 30, 2024 Revised: April 29, 2024 Accepted: May 21, 2024 Published online: June 9, 2024 Processing time: 125 Days and 0.3 Hours
Abstract
BACKGROUND
Pulmonary hypertension (PH) is a serious progressive disorder of the modern world, characterized by endothelial dysfunction and impaired vasoreactivity. Patients with PH usually present exercise intolerance from the very early stages and reduced exercise capacity. Exercise training has been shown to have beneficial effects in patients with cardiovascular comorbidities. However, data regarding the effects of combined exercise training programs in patients with PH still remains limited.
AIM
To investigate the effects of combined exercise training programs on exercise capacity and quality of life in patients with PH.
METHODS
Our search included all available randomized controlled trials (RCTs) regarding combined aerobic, resistance and inspiratory training programs in patients with PH in 4 databases (Pubmed, PEDro, Embase, CINAHL) from 2012 to 2022. Five RCTs were included in the final analysis. Functional capacity, assessed by peak VO2 or 6-min walking test (6MWT), as well as quality of life, assessed by the SF-36 questionnaire, were set as the primary outcomes in our study.
RESULTS
Peak VO2 was measured in 4 out of the 5 RCTs while 6MWT was measured in all RCTs. Both indices of functional capacity were significantly increased in patients with PH who underwent combined exercise training compared to the controls in all of the included RCTs (P < 0.05). Quality of life was measured in 4 out of 5 RCTs. Although patients improved their quality of life in each group, however, only 2 RCTs demonstrated further improvement in patients performing combined training compared to controls.
CONCLUSION
By this systematic review, we have demonstrated that combined aerobic, resistance and inspiratory exercise training is safe and has beneficial effects on aerobic capacity and quality of life in patients with PH. Such exercise training regimen may be part of the therapeutic strategy of the syndrome.
Core Tip: Pulmonary hypertension (PH) is characterized by endothelial dysfunction and impaired vasoreactivity. Data regarding the effects of combined exercise training programs in patients with PH still remains limited. The effects of combined exercise training programs on exercise capacity and quality of life in patients with PH. We observed that combined exercise training has beneficial effects on functional capacity, assessed by peak VO2 or 6-min walking test, and quality of life in PH. However, further research is required in order to create the maximum beneficial individualized exercise training protocols.
