Improving and measuring the function of patients with pulmonary hypertension through rehabilitation

Keen, Carol ORCID: https://orcid.org/0000-0001-7803-1235 (2023) Improving and measuring the function of patients with pulmonary hypertension through rehabilitation. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Pulmonary hypertension is a disorder of the pulmonary circulation which arises from many causes. Regardless of aetiology, pulmonary hypertension results in breathlessness and reduced functional ability, and impacts negatively on survival. There is a growing body of evidence for the benefits of rehabilitation in pulmonary hypertension, and international guidelines recommend its inclusion in patient care pathways. Despite this, access to rehabilitation programmes for patients with pulmonary hypertension in the UK is very limited. This programme of work therefore sought to examine how existing research and knowledge of rehabilitation in patients with pulmonary hypertension could be advanced, with a particular focus on the delivery of rehabilitation in clinical practice for patients with pulmonary hypertension in the UK, and the outcomes used to assess the benefits of rehabilitation. This goal has been achieved through a Review of Service, which described an innovative rehabilitation intervention for patients with pulmonary hypertension, and a Literature Review which highlighted the importance of selecting suitable outcome measures in the design of studies of rehabilitation. In the wake of changes to clinical practice brought about by the COVID-19 pandemic, the PERSPIRE study was undertaken which demonstrated the safety and potential of the 1-minute sit-to-stand test, an outcome which could be used in rehabilitation and in remote assessment. The findings of the completed studies are novel and through their publication and wider dissemination across academic clinical and patient networks have an impact on research, policy and clinical practice. Plans have been made for further research which will continue to develop the findings of the research in this programme of work.