Impact of Pulmonary Rehabilitation on Exercise Capacity, Dyspnea, and Health- Related Quality of Life in Patients with Stable Pulmonary Hypertension: A Randomized Controlled Trial

Background: Pulmonary hypertension (PH) is a progressive disorder characterized by elevated pulmonary artery pressure, right ventricular dysfunction, exercise intolerance, dyspnea, and diminished health-related quality of life (SF-36), despite advances in targeted pharmacotherapy. While pulmonary rehabilitation (PR) has shown promise in meta-analyses, high-quality randomized controlled trials (RCTs) in diverse PH populations (WHO Groups 1– 4) remain limited, particularly with respect to patient-centered outcomes such as dyspnea severity and comprehensive SF-36. Methods: This single-center, parallel-group RCT enrolled 100 adults (aged 18–75 years) with stable PH (WHO Groups 1–4, NYHA class II–III) randomized 1:1 to either an 8-week supervised PR program (twice-weekly sessions including aerobic training, strength exercises, education, and breathing techniques) or usual care. The primary endpoint was change in 6- minute walk distance (6MWD) at week 12; secondary endpoints included modified Medical Research Council (mMRC) dyspnea score and SF-36 Physical and Mental Component Summary (PCS/MCS) scores. Intention-to-treat analysis employed analysis of covariance (ANCOVA) adjusted for baseline values. Results: Compared to usual care, the PR group exhibited significant and clinically meaningful improvements in 6MWD (+50.5 m, 95% CI 47.2–53.7, p