OC 74.5 - Exercise capacity, dyspnoea and health-related quality of life six months after rehabilitation in patients with persistent dyspnoea following pulmonary embolism

Wednesday, June 26, 2024

11:15 – 11:30 ICT

Room: 110 A-C

Presenting Author(s)

Stacey Haukeland-Parker, MSc

PhD candidate
Østfold Hospital
Slependen, Akershus, Norway

Co-Author(s)

�J

Øyvind Jervan

MD. PhD
Ostfold Hospital Trust
Oslo, Oslo, Norway
Waleed Ghanima

Head of Research and Consultant Hematologist
Department of Medicine, Østfold Hospital Trust
Kalnes, Ostfold, Norway
MS

Martijn Spruit

PhD, prof
Department of Research & Development, Ciro, Horn, the Netherlands
Horn, Limburg, Netherlands
RH

Rene Holst

Associate Professor
University of Oslo
Fredrikstad, Ostfold, Norway
JG

Jostein Gleditsch

MD
Department of Radiology, Østfold Hospital Trust
Sarpsborg, Ostfold, Norway
KS

Knut Stavem

MD. PhD. professor
Akershus University Hospital
Oslo, Oslo, Norway
MT

Mazdak Tavoly

PhD, MD
Department of Medicine, Sahlgrenska University Hospital
Gothenburg, Vastra Gotaland, Sweden
KS

Kjetil Steine

Associate professor
Akerhus University Hospital
Oslo, Oslo, Norway
DA

Dan Atar

Professor
University of Oslo / Oslo University Hospital
Oslo, Oslo, Norway
Anders Erik Astrup Dahm

Consultant / Associate Professor
Akershus University Hospital / University of Oslo
Lørenskog, Akershus, Norway
Erik Klok, MD, PhD, FESC

Leiden University Medical Center
HJ

Hege Hølmo Johannessen

Associate Professor / Senior Physiotherapist
Østfold University College / Østfold Hospital
Fredrikstad, Ostfold, Norway

Background: We have previously demonstrated that exercise–based rehabilitation improves exercise capacity in patients with persistent dyspnoea following pulmonary embolism (PE). However, little is known regarding the long-term effect.

Aims: To determine the long-term effect of exercise-based rehabilitation on exercise capacity, dyspnoea and health-related quality of life (HRQoL) between the intervention and control groups in patients with persistent dyspnoea following PE.

Methods: A two-centre, randomised controlled trial compared eight weeks of rehabilitation with standard care in patients with persistent dyspnoea recruited 6-72 months following PE. There was no active intervention following the intervention period. The long-term effect on exercise capacity was assessed six months after completion of the intervention period using the incremental shuttle walk test (ISWT). Secondary endpoints included dyspnoea (Shortness of Breath Questionnaire) and HRQoL (Pulmonary Embolism Quality of Life Questionnaire and EQ-5D-5L). Ethical approval and informed consent were obtained prior to data collection. The study was funded by Østfold Hospital Trust. Our assumptions in the mixed-effect Tobit regression model were no difference in ISWT between groups at baseline and identical differences between groups at follow-up. The model adjusted for baseline ISWT values, centre, age and sex.

Results: 211 patients were included and 132 performed ISWT at six months. Drop-out was similar in both groups (24% vs. 20%). In the rehabilitation group, the significant improvement on the ISWT observed at post-intervention (+93 meters) persisted six-month later (Figure 1). The reductions in dyspnoea were statistically significant at long-term only. No significant improvements in exercise capacity or dyspnea were seen in the control group, and there was no significant difference in HRQoL in either group (Table 1).

Conclusion(s): Exercise-based rehabilitation following PE resulted in improved exercise capacity and dyspnoea at six months post-intervention, however improvement in HRQoL was not detected.