Exercise Rehabilitation Improves Functionality in Pulmonary Embolism Patients

A randomized controlled trial has found that exercise rehabilitation can lead to functional improvements for patients who experience breathing difficulties following a pulmonary embolism (PE). The incremental shuttle walk test (ISWT) scores for the rehabilitation group were significantly higher than the control group (difference 53 m, 95% CI 17.7-88.3, P=0.0035). The patients assigned to rehabilitation also had higher scores on the Pulmonary Embolism Quality of Life questionnaire (PEMB-QoL) than the control group. However, there were no significant differences between the groups on the Endurance Shuttle Walk Test (ESWT), the generic quality of life (QoL) test, or in their dyspnea scores.

Patient Rehabilitation

The study consisted of two 1-hour exercise sessions per week for a total of 8 weeks. Rehabilitation sessions included a warm-up, endurance training, resistance training, and a cool-down at a supervised outpatient location. Patients were also given an at-home exercise regimen to complete one to two times a week. In addition, patients attended a single educational session that discussed PE and its associated anatomy and physiology.

The study found that rehabilitation should be considered in patients with persistent dyspnea following PE. However, further research is needed to assess the optimal patient selection, timing, mode, and duration of rehabilitation. The study adds to the growing evidence of the benefits of rehabilitation after PE and is the largest randomized trial assessing the effect of rehabilitation after PE. The researchers did note that patients in the rehabilitation group were somewhat younger than those in the control group but had worse performance on their baseline ISWT. ISWT scores improved following the intervention. Nevertheless, the ISWT data were subject to a considerable ceiling effect, and patients had varying time differences between their PE and the start of the trial. Several patients either did not complete or withdrew from the study. The study had limitations regarding gaps in hospital records, limits on the types of rehabilitation used, and sample size. Despite the limitations, the study provides valuable information on the benefits of rehabilitation after PE.