Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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An Integrated Outpatient Training Program for Patients with Pulmonary Hypertension - the Munich Pilot Project

Ihle F, Weise S, Waelde A, Meis T, Kneidinger N, Schild C, Zimmermann G, Behr J and Neurohr C

Background: The purpose of this study was to examine the effect of an integrated outpatient training program on exercise capacity and health-related quality of life (HRQOL) in patients with pulmonary hypertension (PH). Methods: 17 patients of our pulmonary hypertension program (World Health Organisation clinical classification system “Dana Point 2008” group 1 n=14, group 4 n=3, age 61±13 years, 11 female [65%], body mass index [BMI] 26.7±5.9) on stable disease-targeted medication attended a supervised integrated outpatient training program including breathing exercises, education, strength and endurance training for 1.5 hours once a month for 10 consecutive months. Patients` exercise capacity was evaluated performing a 6 minute walk test (6MWT), and their quality of life was assessed by the standardized “Short Form 36 Health Survey” and the “Cambridge Pulmonary Hypertension Outcome Review” (CAMPHOR), before and after the program. Data analysis was performed using the paired T-test and Spearman`s rank order correlation. Results: All patients completed the outpatient training while medication remained unchanged during the observational period. At baseline 6-minute walk distance was 383 ± 91 m and after 10 months 391 ± 85 m (p=0.157). Both, HRQOL questionnaires, SF-36 and CAMPHOR, tended to improve with a significant signal only in the CAMPHOR activity core (p < 0.023), indicating improved physical capabilities. During the 10 months observation period no adverse events occurred in the study group. Conclusion: Our data suggest that an integrated outpatient training is safe and may be beneficial as an adjuvant therapeutic option. The correlation between 6MWD and physical domains of HRQOL questionnaires demonstrate the consistency of our data. The best approach for a structured outpatient training for PH patients merits further investigation.