PULMONARY ARTERIAL HYPERTENSION – A CHALLENGE FOR RESPIRATORY REHABILITATION
Chronic pulmonary arterial hypertension (PAH) is a severe disease of the pulmonary vasculature, characterized by increased resistance at this level, and increased pulmonary artery pressure, ultimately leading to right heart failure and death. The current therapeutic strategy in PAH includes a stepwise approach, the first step being supportive therapy, supervised rehabilitation program, and psychosocial support, followed by pharmacological treatment according to the vasoreactive or nonreactive type of PAH and prognostic determinants. Small trials have shown that PAH patients experience reduced dyspnea and fatigue, as well as a higher level of physical activity, a greater distance to the 6-minute walk test, and improvement in the quality of life after completing a pulmonary rehabilitation program. Low-level graded endurance and resistance exercises, as well as inspiratory and peripheral muscles training, are recommended, along with careful patients’ education regarding their own illness, nutrition, and safe level of physical effort. The optimal type of physical activity, intensity, and duration of training are issues still under debate.
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