Supervised pulmonary hypertension exercise rehabilitation (SPHERe): study protocol for a multi-centre randomised controlled trial

McGregor, G.; Bruce, Julie; Ennis, Stuart; Mason, James; Lall, Ranjit; Ji, Chen; Sandhu, Harbinder; Seers, Kate; Banerjee, Prithwish; Canaway, Alastair; Booth, Katie; Taylor, Stephanie J C; Robertson, Elizabeth J.; Pincus, Tamar; Singh, Sally; Fitzmaurice, David; Bowater, Sarah; Clift, Paul; Underwood, Martin

doi:10.1186/s12890-020-01182-y

Cited by 8 publications

(18 citation statements)

References 39 publications

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“…(9) However, there is ample evidence that physical activity can improve endothelial function, exercise capacity and quality of life in patients with chronic arterial disease and chronic left heart failure. (12) The results showed that in 6 minutes the patient was able to cover a distance of 315 meters. Then this distance is useful for determining the dose of rehabilitation carried out.…”

Section: Discussionmentioning

confidence: 97%

“…The effect of exercise training on respiratory muscle strength has been investigated and resulted in a significant increase in VO2 at the anaerobic threshold, indicating an increase in respiratory muscle strength during exercise. (12) A meta-analysis that conducted exercise training studies in cases of chronic thromboembolic pulmonary hypertension (CTEPH) also provided significant results on quality of life where it was stated that physical function, general health perception and even mental health were significantly improved in patients with CTEPH. Exercise exercises combined with pulmonary hypertension-specific drug therapy has shown beneficial effects in patients with CTEPH.…”

Section: Discussionmentioning

confidence: 99%

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Improving Quality of Life in Pulmonary Hypertension with Exercise Training Therapy

Baskarani

Tjahjono

2022

CRJIM

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Pulmonary hypertension is an increase in pulmonary artery pressure >25 mmHg. This causes some disturbing clinical complaints. The most common causes of pulmonary hypertension are idiopathic and congenital heart disease. ASD (Arterial Septal Defect) is a congenital heart disease that occurs in 1.6 per 1000 live births, with a fairly high life expectancy. However, most people with ASD are not aware of a heart problem before the appearance of a clinically significant disorder. Most patients with ASD with complications of pulmonary hypertension will complain of being easily tired, fainting easily and having difficulty carrying out daily activities, even light activities. Most ASD cases apply shunt closure therapy as the main therapy, but not a few ASD cases cannot be shunted closure because it is a contraindication that can lead to more severe complications, especially with complications of chronic pulmonary hypertension. One of the non-medical therapies used to improve the quality of life of patients with pulmonary hypertension is exercise therapy. This therapy provides a variety of physical exercises that aim to increase the strength of respiratory muscles and extremities. From this case, exercise therapy is able to provide a significant improvement in the quality of life of the patient with an increase in the patient's ability to perform physical activities, as evidenced by the increase in distance traveled when doing the six-minute walk test (SMWT).

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Improving Quality of Life in Pulmonary Hypertension with Exercise Training Therapy

Baskarani

Tjahjono

2022

CRJIM

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“…The revised protocol was approved by the funder and independent committees. 39 The online SPHERe intervention was then tested in an internal pilot study.…”

Section: Adaptations Due To Covid-19 Pandemicmentioning

confidence: 99%

“…A separate process evaluation will assess programme acceptability amongst participants and practitioners. 39…”

Section: Intervention Fidelity: Practitioner Training and Quality Con...mentioning

confidence: 99%

Development of an online complex exercise rehabilitation intervention for people with pulmonary hypertension: The Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) Trial

Ennis

Sandhu

Bruce

et al. 2023

Preprint

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Background: People with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite potential for reducing breathlessness and improving quality of life. We describe the development of an online supervised exercise-based rehabilitation programme for people with pulmonary hypertension. Methods: Development was completed in three phases; 1) systematic review, 2) stakeholder engagement with consensus from patients and experts, and 3) intervention feasibility and subsequent internal pilot testing. We completed systematic reviews to identify trials of exercise interventions and international cardiopulmonary guidance for people with pulmonary hypertension. The draft intervention was then ratified through discussions with multidisciplinary professionals and people living with pulmonary hypertension. We tested the SPHERe intervention in an internal pilot study. Adaptations were implemented due to the COVID-19 pandemic. Evidence from systematic reviews and stakeholder consensus from patients and healthcare experts shaped the SPHERe intervention, including addition of individual behavioural education sessions to promote adherence to exercise. Pre-pilot investigation, with eight participants, identified a number of condition-specific issues relating to safety and fear avoidance. Because of the COVID-19 pandemic and lockdown, we adapted the draft intervention for online group delivery. Comprehensive intervention training manuals were produced for practitioners to ensure standardised delivery. Participant workbooks were developed and piloted. Discussion: The final online SPHERe intervention incorporates weekly supervised group exercise and behavioural support ‘coaching’ sessions with trained practitioners, with a home exercise plan and the optional loan of an exercise bike. The intervention is fully manualised with clear pathways for assessment and individualised exercise prescription. This is the first structured online programme for people with pulmonary hypertension. The clinical and cost-effectiveness of the SPHERe intervention is currently being tested in a UK multicentre randomised controlled trial for people with pulmonary hypertension (ISRCTN10608766: Supervised Pulmonary Hypertension Exercise Rehabilitation trial: SPHERe).

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“…One is about the safety, economic applicability, feasibility, and patient compliance of home-based ERT for PH patients, which is supervised by telehealth or distance-based programs [61]. Another one has included clinical deterioration time as the endpoint to evaluate the effectiveness of longterm ERT for PH patients as a routine treatment outside the hospital [62]. A survey composed of 280 physicians, including cardiologists, pulmonologists, rheumatologists, and general practitioners from 22 countries published in 2020, showed that 86% of physicians recommend ERT for patients with PH.…”

Section: Future Directionsmentioning

confidence: 99%

Exercise Rehabilitation Training in Patients With Pulmonary Hypertension: A Review

Dong

2022

Heart, Lung and Circulation

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Supervised pulmonary hypertension exercise rehabilitation (SPHERe): study protocol for a multi-centre randomised controlled trial

Cited by 8 publications

References 39 publications

Improving Quality of Life in Pulmonary Hypertension with Exercise Training Therapy

Improving Quality of Life in Pulmonary Hypertension with Exercise Training Therapy

Development of an online complex exercise rehabilitation intervention for people with pulmonary hypertension: The Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) Trial

Exercise Rehabilitation Training in Patients With Pulmonary Hypertension: A Review

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