SPORTKARDIOLOGIE

Abstract

In this case report, we describe the effects of an outpatient cardiac rehabilitation program that was supplemented by unsupervised home-based exercise training in a patient with a left ventricular assist device (LVAD). This patient performed cycle ergometer as well as resistance training once weekly for 9 months in our outpatient cardiac rehabilitation program and supplemented his home-training as recommended by us with 6 Theraband exercises of 15 repetitions each, at least three days a week. What is unique about this case is the complex clinical status of the patient and his responses with just one supervised training session per week. Since, amongst others, exercise power (Pmax) and quality of life (QOL) improved, this suggests that other compliant patients with VADs may also benefit from an outpatient rehabilitation program, which would decrease resource allocation. Furthermore, combined endurance and resistance exercise training were found to be safe in this case and led to an improvement in Pmax and only a subtle decline in his psychosocial status, which may have been worse without outpatient cardiac rehabilitation as observed in other very ill patients. We could demonstratethat even an LVAD patient can benefit from outpatient cardiac rehabilitation and may eventually be weaned off close supervision. Even though response to rehabilitation will be very individual, especially in these patients, colleagues might feel encouraged by our report to also consider teaching LVAD patients about outpatient cardiac rehabilitation and eventually home-based exercise training.KEY WORDS:Cardiovascular disease, endurance- and resistance  training, physical work capacity, heart failure, Thoratec Heartmate II