Objective: The benefits of exercise training on exercise capacity and quality of life in pulmonary hypertension (PH) have already been shown in several trials. Results of large multicentre studies are still lacking.
Methods: A specialised training program for patients with precapillary PH was implemented in 11 centers across 10 European countries. Patients were randomised in a training group or a sedentary control group. Patients of the training group performed a 10-30 days in-hospital training including interval ergometer training, dumbbell training, mental gait training and respiratory therapy. The training was continued at home until week 15. The primary outcome variable was change in 6-minute walking distance (6MWD) between baseline and 15 weeks in the two groups. Secondary outcome parameters included quality of life scores (SF-36 questionnaire) and peak oxygen consumption during cardiopulmonary exercise testing.
Results: Out of 129 patients who were enrolled, 116 (58 vs. 58) completed the study. Most participating centers implemented this specialised training program for PH for the first time and managed to adapt it to the local health care system. The primary endpoint mean 6MWD significantly improved in the training group vs. control-group by 34.1±8.3 m (p<0.0001). Also, secondary endpoints significantly improved in the training group. Significant improvements of the training group compared to the control group were found in the quality of life parameter mental health (p=0.004), WHO functional class (chi-square p=0.027) and peak oxygen
consumption (control-group corrected improvement 0.9±0.5 mL/min/kg, p=0.048).
Conclusion: This is the first randomized, controlled multicenter study providing evidence of the feasibility of exercise training across ten European countries. Our study results provide
further multicenter evidence of the effect of exercise training programs for PH patients as an add-on therapy. Within this study, a standardized specialized training program with in-hospital
start for PH patients in different European countries was successfully established.