Table S2. Characteristics of the exercise training programs.
| Author | Year | Design | Exercise training group intervention | Control group intervention | Duration | Result |
|---|---|---|---|---|---|---|
| Mereles et al. | 2006 | RCT | • Interval bicycle ergometer training 7 days/week at low workloads • Exercise intensity at 60% to 80% of PeakVO2 • 60 min of walking 5 days/week • 5 days/week of 30 min of resistance training • 30 min of respiratory training 5 days/week • 3 weeks in hospital supervised training followed by 12 weeks training at home |
• Common rehabilitation program based on healthy nutrition, physical therapy such as massages, inhalation, counselling, and muscular relaxation without exercise and respiratory training | 15 weeks | 6MWD ↑; QOL ↑; VO2 (peak+AT) ↑; Workload ↑; WHO FC ↑ |
| Ley et al. | 2013 | RCT | • Same as Mereles et al. 2006 | • Routine daily activities and no specific exercise intervention | 3 weeks | 6MWD ↑; MRI perfusion (pulmonary blood volume) ↑; peak flow↑ |
| Chan et al. | 2013 | RCT | • Aerobic training intervention 24–30 sessions of medically supervised treadmill walking for 30–45 min per session. • Target exercise intensity of 70% to 80% of each patient’s heart rate (HR) reserve obtained from the baseline. • Education intervention. |
• 1 hour of education intervention including lung disease processes, medication use, oxygen therapy, sleep disorders, panic control, relaxation techniques, breathing retraining, community resources etc. | 10 weeks | 6MWD ↑ QOL ↑ |
| Ehlken | 2015 | RCT | • In-hospital training for 3 weeks • Home-based exercise training for 12 weeks • Protocol same as Mereles et al. 2006 |
• Usual care | 15 weeks | peak VO2 ↑; 6MWD ↑; QOL ↑; cardiac index ↑; mPAP↓ |
| Saglam et al. | 2015 | RCT | • Inspiratory muscle training at 30% of the maximum inspiratory pressure which is measured each week • 30 min/day • 7 day/week • 6 weeks |
• Sham inspiratory muscle training at a fixed workload of 10% of the maximum inspiratory pressure; • 30 min/day • 7 day/week • 6 weeks |
6 weeks | 6MWD↑; maximum inspiratory pressure ↑; maximum expiratory pressure↑; FEV1, FVC↑ |
| González-Saiz et al. | 2017 | RCT | • Aerobic training: treadmill dynamometer, 20–40 minutes/session, 5 sessions/week (Monday to Friday), a total of 40 sessions, gradually increase the duration/intensity of each session according to personal situation • Resistance training: 3 sessions/week (Monday, Wednesday and Friday), a total of 24 sessions • Respiratory exercise: 2 sessions/day (one at the hospital in the morning, one at home in the evening), 6 day/week |
• Meet regularly with clinicians | 8 weeks | The improvement of 6MWD was not obvious; muscle strength ↑; PeakVO 2↑ |
| Shigefumi Fukui et al. |
2016 | Non-RCT | • Hospital training for 1 week: walking, bicycle ergometer, low-intensity resistance exercise in lower limbs • Outpatient training for 11 weeks: walking, 30–60 minutes/time, 4–5 times/week; low-intensity resistance exercise in lower limbs, 3 days/week • Patients recorded the time and times of exercise • Educational courses, including lifestyle guidance, counselling, psychological support |
• Maintenance of pulmonary hypertension targeted drug therapy | 12 weeks | 6MWD (−); PeakVO2 ↑; exercise load ↑; QOL↑; Quadriceps strength ↑; WHO FC↑ |
| Martínez-Quintana et al. | 2010 | Non-RCT | • 3 months in-hospital training: 2 days/week • Training sessions with 10 minutes of warming up, brief period of resistance exercise (1–2 kg), interval of bicycle ergometer training (10–25 weeks for 24 minutes, 20–50 weeks for 30 seconds) • 9 months of home training: walk on flat ground every day and do exercises similar to exercise training in hospital |
• Maintain daily activities without special exercise intervention | 12 months | 6MWD (−); QOL ↑; limb strength ↑; WHO FC↑ |
| Fox et al. | 2011 | Non-RCT | • Supervised 24 biweekly 1 hour sessions of exercise training in two 6-week blocks • Exercise intensity at 60% to 80% of peak VO2 In the first block, subjects did interval training with treadmill walking, cycling, and step climbing • In the second block, subjects performed longer periods of continuous aerobic exercise, with resistance training |
• Usual care with maintenance of routine daily activities and no specific exercise intervention | 12 weeks | 6MWD ↑; peak VO2↑ |
| Grünig/Maier et al. | 2012 | Pre-post intervention study | • 3 weeks of supervised training in hospital • 1.5 hours/day, 7 days/week, including interval bicycle ergometer training at low workload (10–60 W), single group muscle training—low workload dumbbell training (500–1,000 g), respiratory training 5 days/week; • 12-week home-based training: more than 30 minutes/day, 5 days/week |
— | 15 weeks | 6MWD ↑; QOL ↑; VO2↑; PASP ↓ (3 weeks) |
| Grünig/Lichtblau et al. | 2012 | Pre-post intervention study | Protocol same as Grünig/Maier et al. 2012 | — | 15 weeks | 6MWD ↑; QOL ↑; peak VO2 ↑; WHO FC ↑; activity tolerance↑ |
| Nagel et al. | 2012 | Pre-post intervention study | Protocol same as Grünig/Maier et al. 2012 | — | 15 weeks | 6MWD ↑; QOL ↑; peak VO2↑; NT-proBNP ↓; (3 weeks) |
| Becker-Grünig et al. | 2013 | Pre-post intervention study | Protocol same as Grünig/Maier et al. 2012. | — | 15 weeks | 6MWD ↑; QOL ↑ |
| Kabitz et al. | 2014 | Pre-post intervention study | Protocol same as Grünig/Maier et al. 2012 | — | 15 weeks | 6MWD ↑; TwPmo↑ |
| Grünig et al. | 2011 | Pre-post intervention study | • 3 weeks of supervised training in hospital • 1.5 hours/day, 7 days/week, including walking, single group muscle training - low workload dumbbell training (500–1,000 g), respiratory training 5 days/week • 24±12 months of Home-based training: a personal training manual, bicycle ergometer training |
— | 15 weeks | 6MWD ↑; QOL ↑; peak VO2 ↑; WHO FC ↑; HRrest ↓; workload↑ |
| Inagaki et al. | 2014 | Pre-post intervention study | • 12 week outpatient rehabilitation program with one in hospital class each week and home based rehabilitation 24–30 sessions over 10 weeks • Combination of strength, endurance and respiratory exercises • Endurance training at 60% of target heart rate |
— | 12 weeks | 6MWD ↑; quadriceps strength↑ |
| de Man et al. | 2009 | Pre-post intervention study | • The standardized exercise protocol adopted from the AHA guidelines for rehabilitation of CHF patients • Supervised exercise training consisted of cycling (based on VO2max assessed at baseline measurements) and quadriceps muscle training (based on repetition maximum assessed on the first day of training) • 3 times/week |
— | 12 weeks | 6MWD (−); peak VO2 (−); endurance improved; No. of capillaries per myocyte ↑; oxidative enzymes ↑ |