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Exercise rehabilitation programmes for pulmonary hypertension: a systematic review of intervention components and reporting quality
  1. Gordon McGregor1,2,
  2. Richard Powell1,
  3. Susanne Finnegan3,
  4. Simon Nichols4,
  5. Martin Underwood3
  1. 1 Department of Cardiopulmonary Rehabilitation, Centre for Exercise & Health, University Hospital, Coventry, UK
  2. 2 School of Health & Life Sciences, Coventry University, Coventry, UK
  3. 3 Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
  4. 4 Sheffield Hallam University, Sheffield, UK
  1. Correspondence to Dr Gordon McGregor; gordon.mcgregor{at}uhcw.nhs.uk

Abstract

Objectives To identify the components, and assess the reporting quality, of exercise training interventions for people living with pulmonary hypertension.

Design Systematic review with analysis of intervention reporting quality using the Consensus on Exercise Reporting Template (CERT).

Data sources Eligible studies in the Cochrane Systematic Review of exercise-based rehabilitation for pulmonary hypertension, updated with a new search of relevant databases from 1 August 2016 to 15 January 2018.

Eligibility criteria Peer-reviewed journal articles of randomised and non-randomised controlled trials, and non-controlled prospective observational studies, investigating dynamic exercise training interventions in adult humans with diagnosed pulmonary hypertension, reporting on at least one physiological and/or psychosocial outcome.

Results Interventions typically involved cycle ergometry and walking. They were delivered as 3-week inpatient, or outpatient and/or home-based programmes, lasting for 4–15 weeks. Components relating specifically to exercise prescription were described satisfactorily and in more detail than motivational/behavioural change strategies, adherence and fidelity. Mean CERT score was 13.1 (range 8–17) out of a possible maximum score of 19. No studies fully reported every aspect of an exercise intervention to the standard recommended by CERT.

Summary/conclusion Considerable variability was evident in the components and reporting quality of interventions for exercise rehabilitation studies in pulmonary hypertension. Interventional studies using exercise training should pay greater attention to describing motivational/behavioural change strategies, adherence and fidelity. Detailed description of these parameters is essential for the safe and effective replication of exercise rehabilitation interventions for pulmonary hypertension in clinical practice.

Trial registration number CRD42018085558.

  • Consensus on Exercise Reporting Template (CERT)
  • exercise rehabilitation
  • pulmonary hypertension

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Footnotes

  • Contributors MU and GM were jointly responsible for the concept of the review. All authors jointly developed the protocol. RP and GM conducted the literature search, and screened and assessed the articles. GM and SF undertook intervention reporting assessment using CERT. GM drafted the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MU has received multiple research grants as chief investigator or co-investigator from the National Institute of Health Research and Arthritis Research UK. He is a shareholder and director in Clinvivo Ltd. He is co-investigator on an NIHR funded trial in which ORTHOSPACE Ltd is providing training and surgical implants. He is part of an academic partnership involving Serco Ltd. GM is a director of Atrium Health Ltd.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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