Abstract
Purpose Continuous flow ventricular assist devices (CF-VADs) are used nowadays in an increasing number of heart failure patients as a bridge or alternative to heart transplantation. Exercise training could improve patient quality of life, however its safety and effectiveness for CF-VAD patients seems not investigated systematically yet. Aim of this study was to analyze exercise training in CF-VAD patients during rehabilitation. Methods and Materials Data collected between 2010 and 2012 during rehabilitation of 41 CF-VAD patients (age 54.8±11.6 y, female 20%) was retrospectively analyzed. The exercise training consisted of bicycle ergometer training (12 modules of increasing intensity), strength training for five muscle groups of the lower limbs, training in walking and gymnastic groups. The number of training sessions as well as the changes in training duration and intensity during the rehabilitation were documented. A subgroup of 15 patients underwent two spiroergometry tests: at the beginning and end of the rehabilitation. Any adverse event related to training was also recorded. Results Patients were admitted to rehabilitation 48±38 days after CF-VAD implantation. During a rehabilitation period of 32±6 days the patients performed 9.6±4.3 sessions of bicycle ergometer training, 6.4±3.1 sessions of strength training, 8.6±4.9 walking sessions and 15.5±6.0 gymnastic sessions. A considerable increase in duration (19±4 vs. 14±2 min) and intensity of bicycle training (module #6.2±2.8 vs. module #2.0±1.9) was observed. Muscular strength (weight lifted) also increased for all muscle groups. The spiroergometry tests showed an increase of the maxVO 2 (14.5±5.2 vs.11.3±4.1 ml/kg/min) and the maximal power (61.5±24.6 vs. 44.4±17.6 W). Only one training-related complication (non-sustained ventricular tachycardia) was observed. Conclusions Exercise training in CF-VAD patients demonstrated to be possible, effective and safe. Physical functional capabilities of CF-VAD patients recover considerably during rehabilitation.
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