Exercise programs for LVAD supported patients: A snapshot from the ESC affiliated countries

• Published in: International journal of cardiology 2015-12, Vol.201, p.215-219
• Main Authors: Ben Gal, Tuvia, Piepoli, Massimo F, Corrà, Ugo, Conraads, Viviane, Adamopoulos, Stamatis, Agostoni, Piergiuseppe, Piotrowicz, Ewa, Schmid, Jean-Paul, Seferovic, Petar M, Ponikowski, Piotr, Filippatos, Gerasimos, Jaarsma, Tiny
• Format: Article
• Language: English
• Subjects: Cardiac rehabilitation; Cardiology - methods; Cardiology - standards; Cardiovascular; Europe - epidemiology; Exercise Therapy - methods; Exercise Therapy - trends; Exercise training; Follow-Up Studies; Heart failure; Heart Failure - diagnosis; Heart Failure - epidemiology; Heart Failure - therapy; Humans; Left ventricular assist device; Societies, Medical - standards; Surveys and Questionnaires
• ISSN: 0167-5273; 1874-1754; 1874-1754
• DOI: 10.1016/j.ijcard.2015.08.081

Abstract Background To contribute to the protocol development of exercise training in LVAD supported patients by reviewing the exercise programs for those patients in the ESC affiliated countries. Methods A subset of data from 77 (26 countries) LVAD implanting centers that participated in the Extra-HF survey (170 centers) was analyzed. Results Of the 77 LVAD implanting centers, 45 (58%) reported to have a functioning exercise training program (ETP) for LVAD patients. In 21 (47%) of the 45 ETP programs in LVAD implanting centers, patients begin their ETP during their in-hospital post-operative recovery period. Most centers (71%) have an early post-discharge program for their patients, and 24% of the centers offer a long-term maintenance program. The professionals involved in the ETPs are mainly physiotherapists (73%), psychologists, cardiac rehab nurses (22%), or cardiologists specialized in rehabilitation (22%). Not all programs include the treating cardiologist or surgeons. Most of the ETPs (84%) include aerobic endurance training, mostly cycling (73%), or walking (62%) at low intensity intervals. Some programs apply resistance training (47%), respiratory muscle training (55%), or balance training (44%). Reasons for the absence of ETPs are referral of patients to another center (14 centers) and lack of resources (11 centers). Conclusion There is a great variance in ETPs in LVAD implanting centers. Not all the implanting centers have an ETP, and those that do have adopted a local protocol. Clear guidance on ETP supplied by LVAD implanting centers to LVAD supported patients and more evidence for optimal modalities are needed.