Patients with persistent dyspnoea after pulmonary embolism likely to benefit from rehabilitation programmes

It is already known that following pulmonary embolism (PE), patients experience persistent dyspnoea, functional limitations and reduced quality of life (QoL). One of the most potent therapeutic options is Rehabilitation, but there remains a lack of scientific evidence.

The question is, does an exercise-based rehabilitation programme improve exercise capacity in such patients?

To research the background mentioned above, researchers conducted a randomized controlled trial at two hospitals. They measured primary (differences in Incremental Shuttle Walk Test (ISWT) and Secondary endpoints (differences in Endurance Shuttle Walk Test (ESWT), QoL (EQ-5D and Pulmonary Embolism-QoL questionnaires) and dyspnoea-related questionnaire.

The summary of the study could be explained as follows:

• There were two groups, Rehabilitation (108 patients) and the control group (103 patients), and patients were randomised in a ratio of 1:1.
• Patients in the rehabilitation programme had two weekly physical exercise sessions for eight weeks and one educational session.
• Patients in the control group received the usual care.
• At follow-up, rehabilitation group participants performed better on the ISWT than the control group, with a mean difference of 53.0 meters.
• The rehabilitation group scored better on the Pulmonary Embolism-QoL questionnaire with a mean difference -of 4% at follow-up.
• Researchers reported no differences in generic QoL, dyspnoea scores, or ESWT.
• No adverse events were reported.

They interpreted the study’s findings as saying following PE, persistent dyspnoea patients receiving Rehabilitation had better exercise capacity at follow-up than the control group.

The study has addressed the importance of Rehabilitation in patients with persistent dyspnoea following PE.

Further investigations are warranted, and more data is required to assess patient selection, timing, mode and duration of Rehabilitation.

Further reading:

The effects of exercise training in patients with persistent dyspnoea after pulmonary embolism: a randomized controlled trial. https://journal.chestnet.org/article/S0012-3692%2823%2900643-8/fulltext