Early Physical Rehabilitation after Continuous Flow Left Ventricular Assist Device Implantation: Suggested Protocol and a Pilot Study
Yair Blumberg1,2 Adi Kravits1, Dina Dinkin1, Arie Neimark3, Miriam Abu-Hatzira3, Rina Shtein1, Vicky Yaari1, Tal Hasin1, Daniel Murninkas1, Benjamin Medalion3, Ran Kornowsky1, Avraham Pinchas1 and Tuvia Ben Gal1*
- *Corresponding Author:
- Tuvia Ben Gal
Heart Failure Unit
Rabin Medical Center (Beilinson campus)
35th Jabotinsky rd., Petah-Tikva
E-mail: [email protected]
Received date: March 08, 2014; Accepted date: February 27, 2015; Published date: March 03, 2015
Citation: Blumberg Y, Kravits A, Dinkin D, Neimark A, Abu-Hatzira M, et al. (2015) Early Physical Rehabilitation after Continuous Flow Left Ventricular Assist Device Implantation: Suggested Protocol and a Pilot Study. Int J Phys Med Rehabil 3:263. doi:10.4172/2329-9096.1000263
Copyright: ©2015 Blumberg Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Left Ventricular Assist Device (LVAD) implantation is an optional therapy for patients with end stage heart failure. Physical rehabilitation after an LVAD implantation is beneficial for the patient's recovery. A detailed protocol for and our experience with a very early post LVAD implantation individualized physical rehabilitation is presented.
Method: Twelve patients who underwent LVAD implantations between April 2010 and April 2011 were included in the study. As soon as the patients were able to walk by themselves (7-10 days post-op), they started aerobic exercise on a treadmill and on the Nustep: combining hand and leg aerobic exercise. Exercise was started at low intensity and for short intervals. The target was to increase intensity and duration. Progress was based on Both Subjective (Borg Scale) and objective (6 Minutes Walk Test: 6MWT) parameters.
Results: Walking time and speed on the treadmill was increased from two 2-4 minutes intervals to one continuous 10 minutes exercise. The time and intensity on the Nustep increased from two intervals of 1-3 minutes to one continuous 16 minutes exercise and from 10-20 watts to 30 watts, respectively. An improvement was seen in the 6MWT from baseline to hospital discharge: 131 ± 91 meters to 262 ± 84 meters respectively (p<0.01) and from discharge to the first LVAD clinic visit: 251 ± 80 meters to 307 ± 88 m meters respectively (p<0.01). All patients reported improvement in carrying the 2-2.5 Kg of battery weight (from difficult to tolerable).
Discussion: A very early stage rehabilitation program after LVAD implantation is feasible and may improve the functional capacity and the ability to carry the LVAD batteries of the LVAD supported patient. Larger studies are needed to determine the optimal time to start rehabilitation program post LVAD implantation.