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Updated: Mar 30, 2026
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Exercise Training in Group 2 Pulmonary Hypertension: Which Intensity and What Modality
Ross Arena1, Carl J Lavie2, Audrey Borghi-Silva3
1Department of Physical Therapy and Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
Exercise training (ET) shows promise for managing pulmonary hypertension (PH) in patients with left-sided heart disease (LSHD). This approach can improve functional capacity and quality of life for individuals with this complex condition.
Area of Science:
- Cardiology
- Pulmonology
- Rehabilitation Medicine
Background:
- Pulmonary hypertension (PH) frequently complicates left-sided heart disease (LSHD), including heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF).
- Elevated left atrial filling pressures in LSHD are a primary driver of PH development.
- Exercise training (ET) is established as beneficial for patients with LSHD, with growing evidence for HFpEF and robust data for HFrEF.
Purpose of the Study:
- To review the role and programming considerations of exercise training (ET) in patients with pulmonary hypertension (PH) secondary to left-sided heart disease (LSHD).
- To synthesize current evidence supporting the application of ET in the LSHD-PH phenotype.
- To guide clinical practice regarding comprehensive rehabilitation strategies for this patient subgroup.
Main Methods:
- Review of existing literature on exercise training in heart failure and pulmonary hypertension.
- Focus on studies examining the effects of aerobic and resistance exercise in LSHD populations.
- Consideration of adjunctive therapies like inspiratory muscle training and neuromuscular electrical stimulation.
Main Results:
- Moderate-intensity aerobic ET improves peak oxygen consumption, quality of life, and prognosis in heart failure patients.
- Resistance ET enhances muscle strength and endurance, further boosting functional capacity.
- Inspiratory muscle training and neuromuscular electrical stimulation are recognized as valuable components of rehabilitation.
Conclusions:
- The existing evidence supports the clinical application of exercise training in patients with LSHD and concomitant PH.
- Tailored ET programs, incorporating aerobic, resistance, and potentially other modalities, can significantly benefit this complex patient group.
- Further research specifically on the LSHD-PH phenotype is warranted to optimize rehabilitation strategies.
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