Effects of Exercise on Muscle Strength and VO2 Peak in Patients with Pulmonary Hypertension: A Systematic Review and Meta-Analysis

Andreas  Rantepadang; Angelia Friska  Tendean; Ellen  Padaunan; I Gede  Purnawinadi; Silvia Dewi Mayasari  Riu; Denny Maurits Ruku

doi:10.60099/prijnr.2025.271912

Authors

Andreas Rantepadang Faculty of Nursing, Klabat University. Manado-Indonesia.
Angelia Friska Tendean Faculty of Nursing, Klabat University. Manado-Indonesia.
Ellen Padaunan Faculty of Nursing, Klabat University. Manado-Indonesia.
I Gede Purnawinadi Faculty of Nursing, Klabat University. Manado-Indonesia.
Silvia Dewi Mayasari Riu Faculty of Nursing, Muhammadiyah University. Manado-Indonesia and Doctoral student at Faculty of Nursing-Airlangga University, Indonesia.
Denny Maurits Ruku Faculty of Nursing, Klabat University. Manado-Indonesia.

DOI:

https://doi.org/10.60099/prijnr.2025.271912

Keywords:

Exercise, Meta-analysis, Muscle strength, Pulmonary hypertension, Systematic review, VO2 peak

Abstract

Exercise programs are one of the treatments used to extend the life expectancy of individuals with pulmonary hypertension; however, there is conflicting evidence regarding how well exercise increases muscle strength and VO2 peak. Six databases and one other source were used in a comprehensive search conducted from June to August 2024 to find relevant research published in English between 2006 and 2022. The standard mean difference, mean difference, and risk difference with a 95% confidence interval were used to determine the effect of exercise. Biased publications were presented with a risk of bias summary/graph. Employing the Critical Appraisal Skills Program, all reviewers independently assessed the methodological quality of the included studies and extracted data.

The results showed 13 randomized control trial studies with 421 respondents, consisting of 204 and 217 in the intervention and control groups, respectively. Exercise had significant effects on improving muscle strength, VO2 peak (primary outcomes), oxygen saturation, cardiac output, six-minute walk test, and several aspects of health-related quality of life as assessed by the SF-36 questionnaire (secondary outcomes), and there were no serious adverse events linked to exercise. However, exercise did not significantly alter VE/VCO2 slope, cardiac index, role physical, vitality, mental health, physical component summary, or mental component summary between the intervention than control groups among people with pulmonary hypertension. In conclusion, an exercise program of supervised may improve VO2 peak and muscle strength and does not result in an increased risk of serious adverse events. Nonetheless, individuals with severe conditions of pulmonary hypertension should be carefully considered when doing exercise programs.

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