Supervised Versus Unsupervised Pulmonary Rehabilitation in Patients with Pulmonary Embolism: A Valuable Alternative in COVID Era.

The aim of our study was to assess the effect of 8 weeks of pulmonary rehabilitation (PR) in patients with pulmonary embolism (PE) during unsupervised PR (unSPR group ) versus supervised PR (SPR group ) on cardiopulmonary exercise testing (CPET) parameters, sleep quality, quality of life and cardiac biomarkers (NT-pro-BNP). Fourteen patients with PE (unSPR group , n = 7, vs. SPR group , n = 7) were included in our study (age, 50.7 ± 15.1 years; BMI, 30.0 ± 3.3 kg/m 2 ). We recorded anthropometric characteristics and questionnaires (Quality of life (SF-36) and Pittsburg sleep quality index (PSQI)), we performed blood sampling for NT-pro-BNP measurement and underwent CPET until exhausting before and after the PR program. All patients were subjected to transthoracic echocardiography prior to PR. The SPR group differed in mean arterial pressure at rest before and after the PR program (87.6 ± 3.3 vs. 95.0 ± 5.5, respectively, p = 0.010). Patients showed increased levels of leg fatigue (rated after CPET) before and after PR ( p = 0.043 for SPR group , p = 0.047 for unSPR group ) while the two groups differed between each other ( p = 0.006 for post PR score). Both groups showed increased levels in SF-36 scores (general health; p = 0.032 for SPR group , p = 0.010 for unSPR group ; physical health; p = 0.009 for SPR group , p = 0.022 for unSPR group ) and reduced levels in PSQI (cannot get to sleep within 30-min; p = 0.046 for SPR group , p = 0.007 for unSPR group ; keep up enough enthusiasm to get things done; p = 0.005 for SPR group , p = 0.010 for unSPR group ) following the PR program. The ΝT-pro-BNP was not significantly different before and after PR or between groups. PR may present a safe intervention in patients with PE. The PR results are similar in SPR group and unSPR group .