Individually tailored home-based physiotherapy programs for patients with pulmonary arterial hypertension (PAH) were able to increase daily physical activity and exercise capacity, according to a study published in Therapeutic Advances in Respiratory Disease. 

PAH is characterized by high pulmonary arterial pressures that drive right ventricular failure. In addition, increased resistance in the pulmonary vasculature impairs the adequate exchange of gas in the alveoli, reducing oxygen saturation in the blood. PAH often manifests as low exercise tolerance, with symptoms including dyspnea, fatigue, chest pain, and syncope. 

Advances in PAH therapeutics have improved the clinical picture of patients, but exercise tolerance remains a notable complaint. In 2019, the European Respiratory Society issued a statement recommending individually tailored and supervised exercise programs for patients with PAH to improve their exercise capacity, muscle performance, and quality of life. 


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The authors of the study presented an analysis of the secondary outcomes from a recently completed clinical trial that looked into the effectiveness of individually tailored physiotherapy programs in patients who were stable on medical therapy. A 12-week, home-based physiotherapy program was analyzed for its effectiveness in increasing daily physical activity and exercise capacity immediately after completion and 6 months after commencement. 

Read more about PAH epidemiology 

The physiotherapy program was led by a specialized physiotherapist who tailored the exercises prescribed according to individual needs. The exercises were a mixture of aerobic activity, strength training, and inspiratory muscle training. Patients were requested to fill in a daily study diary to enhance compliance. Eleven patients were in the training group and 10 were in the control. 

“The study results confirm that an individually tailored home-based physiotherapy program significantly improves exercise capacity for patients with PAH, who are on stable medical target therapy, not only immediately after completing the program but also long-term,” the authors wrote. 

The feasibility of home-based physiotherapy programs is encouraging given that programs only available at hospital settings limit accessibility and tend to be more costly. 

Reference

Butāne L, Spilva-Ekerte L, Šablinskis M, Skride A, Šmite D. Individually tailored home-based physiotherapy program makes sustainable improvement in exercise capacity and daily physical activity in patients with pulmonary arterial hypertensionTher Adv Respir Dis. 2022;16:17534666221132477. doi:10.1177/17534666221132477