Abstract
Background/Objectives: Pulmonary embolism (PE) is a life-threatening condition that frequently results in persistent exertional dyspnea, reduced exercise tolerance, and psychological distress, even after acute-phase management. Despite growing recognition of post-PE impairments, structured early rehabilitation remains underutilized. This narrative review aims to evaluate current evidence on the role, components, and outcomes of early rehabilitation strategies following acute PE. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology, a comprehensive literature search was conducted across PubMed, Embase, Scopus, Web of Science, Google Scholar, and the Cochrane Library. Articles published between 2020 and 2025 were screened for relevance to early rehabilitation in PE patients. Inclusion criteria prioritized randomized controlled trials, prospective studies, meta-analyses, and systematic reviews. Study quality was assessed using Cochrane, Newcastle-Ottawa, and AMSTAR 2 tools. Results: Out of 306 records, 158 studies were included. Early pulmonary rehabilitation-including aerobic and resistance exercise, inspiratory muscle training, and psychological support-demonstrated improvements in functional capacity, dyspnea, and quality of life, without adverse effects. Supplementation with omega-3 fatty acids and vitamin D may further mitigate thromboembolic risk via anti-inflammatory pathways. However, evidence remains predominantly observational, with limited high-quality data addressing timing, dosage, and patient stratification. Conclusions: Early, individualized rehabilitation appears safe and potentially beneficial in improving recovery and limiting complications after acute PE. Nonetheless, the absence of robust randomized trials underscores the urgent need for hypothesis-driven research to establish standardized, evidence-based rehabilitation protocols and guidelines tailored to risk stratification and patient phenotype, so as not to prolong recovery time and keep survivors from becoming disabled.