Safety and efficacy of cardiac rehabilitation for patients with continuous flow left ventricular assist devices

Abstract

Exercise training for LVAD patient as part of a multidisciplinary rehabilitation programme is effective and safe. This warrants the broad application of exercise training after LVAD implantation.

Exercise Capacity and Functional Performance in Heart Failure Patients Supported by a Left Ventricular Assist Device at Discharge From Inpatient Rehabilitation

“…At maximum load, a mean RER of 1.11 (60.07) and a mean lactate concentration of 3.82 (61.0) mmol/L could be measured. Similarly high levels were attained in comparable studies (RER between 1.07 and 1.26 [10,13,[38][39][40]). As the peak exertion level criterion for CPET in healthy subjects, Kroidl et al (16) recommend an RER of >1.11 and an RER of >1.05 in cardiac patients.…”

“…Table 4 summarizes the results of comparable studies which conducted a CPET shortly after LVAD implantation (90 days). In most investigations, comparably low values were recorded (10,13,25,38,39,41 remained unchanged over time at the same (low) levels (12.66 mL/kg/min after 3-6 months, 10.74 mL/kg/min after 1 year, and 11.18 mL/kg/min after more than 1 year). For comparison, patients after heart transplantation usually reach average values of 17-20 mL/kg/min (60-70% of predicted values) in the long term (45).…”

“…Table 4 summarizes the results of comparable studies which conducted a CPET shortly after LVAD implantation (90 days). In most investigations, comparably low values were recorded (10,13,25,38,39,41 …”

“…Cardiac rehabilitation (CR) can and should make an important contribution in this context (3,4). After being discharged from a CR center the patients should once more become able to autonomously manage the necessary tasks in their everyday lives back home.Over the last few years, several studies have emerged, most of them small, which report results following rehabilitation (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). In these studies, physical performance at the end of CR was evaluated using different measuring techniques (functional independence measures [FIM], treadmill ergometry, bicycle ergometry, strength tests, and 6-min walk test [6MWT]).…”

Physical rehabilitation of patients after heart transplantation

“…Помимо тренировок дыхательной мускулатуры [27], у данной категории паци-ентов возможно использование и других видов упражне-ний, таких как аэробные с постоянным уровнем нагрузки [37,38] или интенсивные ИТ [39], а также локальные тренировки, увеличивающие силу мышц [34].…”