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Development of a Complex Exercise Rehabilitation Intervention for People with Pulmonary Hypertension: The Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) Trial
Stuart Ennis
University Hospitals Coventry and Warwickshire NHS Trust
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7176-6252
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Background: People with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite the potential for reducing breathlessness and improving quality of life. We describe the development of a supervised exercise-based rehabilitation programme for this group. The intervention will be tested in a randomised controlled trial (Supervised Pulmonary Hypertension Exercise Rehabilitation trial: SPHERe).
Methods: Work was completed in three phases; 1) systematic review, 2) stakeholder engagement with consensus from expert opinion, and 3) intervention piloting and acceptability testing. Our systematic reviews identified exercise interventions for pulmonary hypertension. The draft intervention was ratified through discussions with representatives from medicine, exercise physiology, psychology, and patients. We subsequently assessed the SPHERe intervention in a pre-pilot.
Results: Systematic reviews report that exercise might be safe and effective in this population. We found that other exercise interventions were within existing international cardiopulmonary rehabilitation guidelines. Stakeholder opinion and consensus shaped components of the SPHERe intervention, including addition of individual behavioural education sessions to promote adherence to exercise. Our pre-pilot investigation identified a number of condition-specific issues relating to safety and fear avoidance. We addressed these by adding two familiarisation sessions. The development of comprehensive intervention training manuals for participants and practitioners will ensure standardised delivery.
Discussion: The SPHERe intervention incorporates three main components: supervised gym exercise, behavioural strategies to encourage adherence, and a home exercise plan for people with pulmonary hypertension. We will evaluate the clinical and cost-effectiveness of the SPHERe intervention in a multicentre randomised controlled trial for people with pulmonary hypertension (ISCRTN no.:10608766)
Keywords
Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe), pulmonary hypertension (PH), PAH, rehabilitation
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CURRENT STATUS: Under Review
Version 1
Posted 13 Aug, 2020
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Reviewers invited
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On 11 Aug, 2020
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Subject Areas
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This preprint is under consideration at Pilot and Feasibility Studies. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Development of a Complex Exercise Rehabilitation Intervention for People with Pulmonary Hypertension: The Supervised Pulmonary Hypertension Exercise Rehabilitation (SPHERe) Trial
Stuart Ennis
University Hospitals Coventry and Warwickshire NHS Trust
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7176-6252
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 13 Aug, 2020
No community comments so far
Reviewers invited
Invitations sent on 09 Sep, 2020
Editor assigned
On 11 Aug, 2020
First submitted
On 10 Aug, 2020
Submission checks complete
On 10 Aug, 2020
Editor invited
On 10 Aug, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Physical Medicine & Rehab
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: People with pulmonary hypertension (PH) are not routinely referred for exercise rehabilitation despite the potential for reducing breathlessness and improving quality of life. We describe the development of a supervised exercise-based rehabilitation programme for this group. The intervention will be tested in a randomised controlled trial (Supervised Pulmonary Hypertension Exercise Rehabilitation trial: SPHERe).
Methods: Work was completed in three phases; 1) systematic review, 2) stakeholder engagement with consensus from expert opinion, and 3) intervention piloting and acceptability testing. Our systematic reviews identified exercise interventions for pulmonary hypertension. The draft intervention was ratified through discussions with representatives from medicine, exercise physiology, psychology, and patients. We subsequently assessed the SPHERe intervention in a pre-pilot.
Results: Systematic reviews report that exercise might be safe and effective in this population. We found that other exercise interventions were within existing international cardiopulmonary rehabilitation guidelines. Stakeholder opinion and consensus shaped components of the SPHERe intervention, including addition of individual behavioural education sessions to promote adherence to exercise. Our pre-pilot investigation identified a number of condition-specific issues relating to safety and fear avoidance. We addressed these by adding two familiarisation sessions. The development of comprehensive intervention training manuals for participants and practitioners will ensure standardised delivery.
Discussion: The SPHERe intervention incorporates three main components: supervised gym exercise, behavioural strategies to encourage adherence, and a home exercise plan for people with pulmonary hypertension. We will evaluate the clinical and cost-effectiveness of the SPHERe intervention in a multicentre randomised controlled trial for people with pulmonary hypertension (ISCRTN no.:10608766)
Figure 1
Figure 2
Figure 3
Figure 4