Demand for exercise training in patients with pulmonary arterial hypertension in Scotland

MacKenzie, Alison; Johnson, Martin K.

doi:10.1183/13993003.00716-2015

Cited by 3 publications

(8 citation statements)

References 4 publications

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“…That allowed us to treat patients without any additional charges. Before 2015, many European countries, such as the United Kingdom, Ireland, Spain, and others, had no dedicated exercise training programs for PH patients, and some of them had no possibilities for an in-hospital start of PH rehabilitation, which is preferable [16]. Meanwhile, the experience in PH rehabilitation of the Heidelberg program is >15 years.…”

Section: Discussion/conclusionmentioning

confidence: 99%

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The Experience, Prerequisites, and the Barriers in Organizing a Specialized Rehabilitation Program for Patients with Pulmonary Hypertension

et al. 2021

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Background: Pulmonary hypertension (PH) is a severe progressive disease, associated with reduced exercise capacity and poor quality of life. Although scientific evidence supports the incorporation of specialized training in the treatment of PH, it is only available in a few countries. Objectives and Methods: This article aims to share the experience of implementing a PH rehabilitation program, to summarize the barriers and prerequisites for launching this service, and to assess its early effect. We retrospectively analyzed our pathway in organizing this program, by singling out essential steps. Results: The preparation phase took about 14 months. Establishing and running of a PH rehabilitation program required dedicated rehabilitation specialists to join the multidisciplinary PH expert team. Team members needed to gain special knowledge on exercise training in severely compromised patients; thus, supervision and education by experienced consultants was crucial. The main eligibility criteria for patients were stable status, optimal medical treatment, and motivation to undergo the training. The first results evaluating the effect of a specialized PH training program in 9 patients are promising. Seven of them improved their functional capacity over the period of 15 weeks. Conclusions: Despite a number of challenges and barriers, the implementation of a specialized rehabilitation program should be encouraged in a few dedicated PH expert centers per country, who are capable to fulfill all prerequisites and organizational aspects. Local PH experts, supervision by an experienced center, in-patient rehabilitation facilities, dedicated personnel, equipment, and patient motivation are essential.

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Section: Discussion/conclusionmentioning

confidence: 99%

“…Importantly, practical experience shows that most PH patients are highly motivated to participate in a specialized rehabilitation program [16]. Limited availability and underutilization of exercise training remains a drawback in many specialized PH centers.…”

Section: Introductionmentioning

confidence: 99%

The Experience, Prerequisites, and the Barriers in Organizing a Specialized Rehabilitation Program for Patients with Pulmonary Hypertension

et al. 2021

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“…Age and WHO functional class were adjusted for as both have previously been shown to be associated with increased interest in exercise rehabilitation. 12 Referral to exercise rehabilitation was the primary dependent variable.…”

Section: Methodsmentioning

confidence: 99%

“…Despite the guideline recommendations, the extent to which PAH patients are utilizing exercise rehabilitation is currently limited. 12 Studies in chronic cardiopulmonary illnesses where patients receive a similar benefit from exercise have identified unique predictors of referral 13–19 and barriers to the uptake of exercise rehabilitation. 20–23 While some overlap may exist, these challenges may differ in PAH patients due to their unique pathophysiology and barriers such as travel to specialized centers with experience performing exercise rehabilitation with PAH patients.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the guideline recommendations, the extent to which PAH patients are utilizing exercise rehabilitation is currently limited 12 . Studies in chronic cardiopulmonary illnesses where patients receive a similar benefit from exercise have identified unique predictors of referral 13–19 and barriers to the uptake of exercise rehabilitation 20–23 .…”

Section: Introductionmentioning

confidence: 99%

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Impact of patient characteristics and perceived barriers on referral to exercise rehabilitation among patients with pulmonary hypertension in the United States

et al. 2020

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Exercise rehabilitation is underutilized in patients with pulmonary arterial hypertension (PAH) despite improving exercise capacity and quality of life. We sought to understand the association between (1) patient characteristics and (2) patient-perceived barriers and referral to exercise rehabilitation. We performed a cross-sectional survey of patients with PAH or chronic thromboembolic pulmonary hypertension attending an International PAH meeting. Predictors of referral considered included gender, body mass index, subjective socioeconomic status, insurance type, age, and World Health Organization functional class and perceived barriers assessed using the Cardiac Rehabilitation Barriers Scale. Among 65 participants, those in the lowest subjective socioeconomic status tertile had reduced odds of referral compared to the highest tertile participants (OR 0.22, 95% CI; 0.05 â 0.98, p = 0.047). Several patient-perceived barriers were associated with reduced odds of referral. For every 1-unit increase in a reported barrier on a 5-point Likert scale, odds of referral were reduced by 85% for my doctor did not feel it was necessary, 85% for prefer to take care of my health alone, not in a group, 78% many people with heart and lung problems donât go, and they are fine, and 78% for I didnât know about exercise therapy. The lack of perceived need subscale and overall barriers score were associated with a 92% and 77% reduced odds of referral, respectively. These data suggest the need to explore interventions to promote referral among low socioeconomic status patients and address perceived need for the therapy.

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Effect of EPOC on Serum MicroRNA Expression in Patients with Hypertension

2022

Journal of Healthcare Engineering

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In order to analyze the effect of EPOC on serum microRNA expression in patients with hypertension, we have carried out an experimental evaluation and presented a dedicated method to improve its effectiveness. For this purpose, 60 patients with hypertension treated in our hospital from January to December 2020 were selected and randomly divided into the EPOC group (30 cases) and the control group (30 cases). Patients in both groups received conventional hypertension medication according to the treatment guidelines, and education and guidance were strengthened to ensure patients’ drug compliance. The EPOC group received EPOC training in addition to conventional medication. After the intervention, 6MWD, LVEF, and LVEDD in the control group and the EPOC group were significantly improved compared with that before treatment ( P < 0.05). The improvement of cardiac function in the EPOC group was significantly better than that in the control group ( P < 0.05). Physiological function, physiological characteristics, body pain, and general health of the control group and the EPOC group were significantly improved compared with that before treatment ( P < 0.05). The improvement of quality of life in the EPOC group was significantly better than that in the control group ( P < 0.05). The indexes of heart rate, oxygen pulse, minute ventilation, oxygen uptake in kg, and anaerobic threshold in the EPOC group were significantly better than those in the control group before and after treatment ( P < 0.05). Full-sample real-time PCR verification of the 8 miRNAs with the highest expression differentiation showed that, compared with the control group, the expression levels of miR-20a-5p, miR-93-5p, and miR-1287-5p in the serum of the EPOC group were significantly increased, while the expression levels of miR-7706, miR-28-5p, and miR-125b-5p were significantly decreased. The expression of miR-20a-5p was the highest, while the expression of miR-125b-5p was the lowest, suggesting that miR-20a-5p and miR-125b-5p might be involved in the process of HIIT to improve hypertension. After EPOC rehabilitation treatment, patients’ heart function indexes, lung function indexes, and quality of life have been significantly improved. EPOC rehabilitation can improve exercise tolerance, enhance cardiopulmonary function, and improve the prognosis of patients.

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Demand for exercise training in patients with pulmonary arterial hypertension in Scotland

Cited by 3 publications

References 4 publications

The Experience, Prerequisites, and the Barriers in Organizing a Specialized Rehabilitation Program for Patients with Pulmonary Hypertension

The Experience, Prerequisites, and the Barriers in Organizing a Specialized Rehabilitation Program for Patients with Pulmonary Hypertension

Impact of patient characteristics and perceived barriers on referral to exercise rehabilitation among patients with pulmonary hypertension in the United States

Effect of EPOC on Serum MicroRNA Expression in Patients with Hypertension

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