TITLE:
Exercise-Based Rehabilitation for Patients with Pulmonary Embolism—A Narrative Review
AUTHORS:
Roland Nebel, Birna Bjarnason-Wehrens, Thomas Schmidt
KEYWORDS:
Chronic Thromboembolic Pulmonary Hypertension, Post-Pulmonary Embolism Syndrome, Exercise Therapy, Cardiac Rehabilitation
JOURNAL NAME:
Open Journal of Therapy and Rehabilitation,
Vol.14 No.2,
May
25,
2026
ABSTRACT: Introduction: Pulmonary embolism (PE) is the third leading cause of cardiovascular death worldwide. If left untreated, the mortality rate is 25% to 30%. PE can have far-reaching long-term health consequences, like development of chronic thromboembolic pulmonary hypertension (CTEPH) or post-pulmonary embolism syndrome (PPES). PE is often associated with persistent symptoms or limitations in physical performance and affects quality-of-life, personal, family and professional circumstances. This review summarizes available evidence on feasibility, safety and effectiveness of exercise-based cardiac/pulmonary rehabilitation in PE-patients. Methods: A selective literature search was conducted in PubMed using predefined search terms. In addition, the bibliographies of all available studies and guidelines were consulted in order to identify any further sources. Results: Sixteen mostly small studies were identified. A considerable heterogeneity regarding study design, patient characteristics, intervention setting, duration, scope, and contents and outcome parameters was observed. Results demonstrate feasibility, safety, and/or efficacy of exercise-based interventions in PE patients. The intervention was well tolerated, and no serious events related to the exercise were documented. The interventions lead to a prolonged 6-minute walk distance, improved physical performance, quality of life, hemodynamic parameters, arterial oxygen saturation, oxygen uptake (peak VO2max) and further respiratory parameters. Nevertheless, the evidence for benefit and efficiency remains mixed: the largest acute PE trial did not show superiority on its primary endpoint. Discussion: There is a significant need for structured follow-up-care, including rehabilitation for PE-patients. Despite frequent occurrence and potential physical and psychosocial consequences for those affected, there are no structured aftercare or rehabilitation programs in the first year after PE. Only a few studies have focused on the effects of a structured rehabilitation or aftercare program following PE. Conclusions: There is a considerable need for improved scientific evidence, targeted and structured care pathways, and interdisciplinary cardiac/pulmonary rehabilitation in PE-patients.