title: Feasibility and safety of rehabilitation after venous thromboembolism.
abstract: BACKGROUND
  Venous thromboembolism is a life-threatening disease. In survivors, different degrees of functional complaints need to be restored or prevented (eg, post-thrombotic syndrome, pulmonary hypertension). Therefore, rehabilitation after venous thromboembolism is recommended in Germany. However, a structured rehabilitation program has not been defined for this indication. Here, we present the experience of a single rehabilitation center.
  
  
  METHODS
  Data from consecutive pulmonary embolism (PE) patients who were referred for a 3-week inpatient rehabilitation program from 2006 to 2014 were retrospectively evaluated.
  
  
  RESULTS
  In all, 422 patients were identified. The mean age was 63.9±13.5 years, the mean body mass index (BMI) was 30.6±6.2 kg/m2, and 51.9% were female. Deep vein thrombosis according to PE was known for 55.5% of all patients. We applied a wide range of therapeutic interventions such as bicycle training with monitored heart rate in 86.7%, respiratory training in 82.5%, aquatic therapy/swimming in 40.1%, and medical training therapy in 14.9% of all patients. Adverse events (AEs) occurred in 57 patients during the 3-week rehabilitation period. The most common AEs were cold (n=6), diarrhea (n=5), and infection of the upper or lower respiratory tract that was treated with antibiotics (n=5). However, three patients under anticoagulation therapy suffered from bleeding, which was clinically relevant in one. Four patients (0.9%) had to be transferred to a primary care hospital for non-PE-associated reasons (acute coronary syndrome, pharyngeal abscess, and acute abdominal problems). No influence of any of the physical activity interventions on the incidence of any AE was found.
  
  
  CONCLUSIONS
  Since PE is a life-threatening disease, it seems reasonable to recommend rehabilitation at least in PE patients with an intermediate or high risk. It is shown for the first time in this study that a standard rehabilitation program after PE is safe. However, efficacy and safety in the long term need to be studied prospectively.
authors.affiliation: Department of Medicine I, University Clinic Halle (Saale), Halle, Germany ; Department of Emergency Medicine, University Clinic Halle (Saale), Halle, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Noack
authors.affiliation: Department of Medicine I, University Clinic Halle (Saale), Halle, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Schmidt
authors.affiliation: Department of Emergency Medicine, University Clinic Halle (Saale), Halle, Germany.
authors.forename: Mroawan
authors.initials: M
authors.lastname: Amoury
authors.affiliation: Department of Diagnostic Radiology, University Clinic Halle (Saale), Halle, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Stoevesandt
authors.affiliation: Department of Medicine III, University Clinic Halle (Saale), Halle, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Gielen
authors.affiliation: Department of Cardiology and Pulmology, Paracelsus-Harz-Clinic Bad Suderode, Quedlinburg, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Pflaumbaum
authors.affiliation: Department of Cardiology and Pulmology, Paracelsus-Harz-Clinic Bad Suderode, Quedlinburg, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Girschick
authors.affiliation: Klinik am See, Rüdersdorf, Germany.
authors.forename: Heinz
authors.initials: H
authors.lastname: Völler
authors.affiliation: Department of Cardiology and Pulmology, Paracelsus-Harz-Clinic Bad Suderode, Quedlinburg, Germany ; Medical Faculty, Martin Luther University Halle, Wittenberg, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Schlitt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001642:Bicycling; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000534:rehabilitation*; D012307:Risk Factors; D013550:Swimming; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000188:drug therapy / Q000517:prevention & control* / Q000534:rehabilitation*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D000925:Anticoagulants
keywords: pulmonary embolism; rehabilitation; venous thromboembolism