Supervised Versus Unsupervised Pulmonary Rehabilitation in Patients with Pulmonary Embolism: A Valuable Alternative in COVID Era

肺栓塞患者的监督式肺康复与非监督式肺康复:新冠疫情时代的一种有效替代方案

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Abstract

The aim of our study was to assess the effect of 8 weeks of pulmonary rehabilitation (PR) in patients with pulmonary embolism (PE) during unsupervised PR (unSPR(group)) versus supervised PR (SPR(group)) on cardiopulmonary exercise testing (CPET) parameters, sleep quality, quality of life and cardiac biomarkers (NT-pro-BNP). Fourteen patients with PE (unSPR(group), n = 7, vs. SPR(group), n = 7) were included in our study (age, 50.7 ± 15.1 years; BMI, 30.0 ± 3.3 kg/m(2)). We recorded anthropometric characteristics and questionnaires (Quality of life (SF-36) and Pittsburg sleep quality index (PSQI)), we performed blood sampling for NT-pro-BNP measurement and underwent CPET until exhausting before and after the PR program. All patients were subjected to transthoracic echocardiography prior to PR. The SPR(group) differed in mean arterial pressure at rest before and after the PR program (87.6 ± 3.3 vs. 95.0 ± 5.5, respectively, p = 0.010). Patients showed increased levels of leg fatigue (rated after CPET) before and after PR (p = 0.043 for SPR(group), p = 0.047 for unSPR(group)) while the two groups differed between each other (p = 0.006 for post PR score). Both groups showed increased levels in SF-36 scores (general health; p = 0.032 for SPR(group), p = 0.010 for unSPR(group); physical health; p = 0.009 for SPR(group), p = 0.022 for unSPR(group)) and reduced levels in PSQI (cannot get to sleep within 30-min; p = 0.046 for SPR(group), p = 0.007 for unSPR(group); keep up enough enthusiasm to get things done; p = 0.005 for SPR(group), p = 0.010 for unSPR(group)) following the PR program. The ΝT-pro-BNP was not significantly different before and after PR or between groups. PR may present a safe intervention in patients with PE. The PR results are similar in SPR(group) and unSPR(group).

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