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Open Access Study protocol

Short term effects of exercise training on exercise capacity and quality of life in patients with pulmonary arterial hypertension: protocol for a randomised controlled trial

Louise Ganderton123*, Sue Jenkins134, Kevin Gain125, Robin Fowler123, Peta Winship2, Dianne Lunt2 and Eli Gabbay12356

Author Affiliations

1 School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Perth, Australia

2 Royal Perth Hospital, Perth, Australia

3 Lung Institute of Western Australia, Centre for Asthma, Allergy and Respiratory Research, University of Western Australia

4 Sir Charles Gairdner Hospital, Perth, Australia

5 School of Medicine and Pharmacology, University of Western Australia, Perth, Australia

6 School of Medicine, University of Notre Dame, Fremantle, Australia

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BMC Pulmonary Medicine 2011, 11:25  doi:10.1186/1471-2466-11-25

Published: 23 May 2011

Abstract

Background

Advances in the understanding and management of pulmonary arterial hypertension have enabled earlier diagnosis and improved prognosis. However, despite best available therapy, symptoms of exertional dyspnoea and fatigue are commonly reported and result in a reduced capacity to perform daily activities and impaired quality of life. Exercise training has demonstrated efficacy in individuals with other respiratory and cardiovascular diseases. Historically, however, exercise training has not been utilised as a form of therapy in pulmonary arterial hypertension due to the perceived risk of sudden cardiac death and the theoretical possibility that exercise would lead to worsening pulmonary vascular haemodynamics and deterioration in right heart function. Now, with the advances in pharmaceutical management, determining the safety and benefits of exercise training in this population has become more relevant. Only three studies of supervised exercise training in pulmonary arterial hypertension have been published. These studies demonstrated improvements in exercise capacity and quality of life, in the absence of adverse events or clinical deterioration. However, these studies have not utilised an outpatient-based, whole body exercise training program, the most common format for exercise programs within Australia. It is uncertain whether this form of training is beneficial and capable of producing sustained benefits in exercise capacity and quality of life in this population.

Design/Methods

This randomised controlled trial will determine whether a 12 week, outpatient-based, supervised, whole body exercise training program, followed by a home-based exercise program, is safe and improves exercise capacity and quality of life in individuals with pulmonary arterial hypertension. This study aims to recruit 34 subjects who will be randomly allocated to the exercise group (supervised exercise training 3 times a week for 12 weeks, followed by 3 sessions per week of home exercise for 12 weeks) or the control group (usual medical care). Subjects will be assessed at baseline, 12 weeks and 24 weeks.

Discussion

This study will determine whether outpatient-based, whole body exercise training is beneficial and safe in individuals with pulmonary arterial hypertension. Additionally, this study will contribute to clinical practice guidelines for this patient population.

Trial registration

Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12609000502235