Department for Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany (Drs Hildebrandt, Willemsen, Reiss, Bartsch, and Schmidt); and Institute of Cardiology and Sports Medicine, Department for Preventive and Rehabilitative Sport and Exercise Medicine, German Sports University Cologne, Cologne, Germany (Drs Hildebrandt, Schmidt, and Bjarnason-Wehrens).
J Cardiopulm Rehabil Prev. 2019 Mar;39(2):91-96. doi: 10.1097/HCR.0000000000000342.
With an increasing number of left ventricular assist devices (LVADs) being implanted, the need for adequate cardiac rehabilitation (CR) regimens meeting the special needs of these patients arises. Only a few studies have reported experience gained on this topic. Structured CR strategies are poorly implemented. The aim was to evaluate the characteristics, therapeutic needs, and scope of LVAD patients at admission to CR within a greater cohort in order to identify their special CR needs.
Retrospective single-center study; 69 LVAD patients (50.7 ± 13.6 y; 59 male; 48 HVAD; 21 HeartMate II) who completed first inpatient CR were included. Patient records were used to document relevant medical information (including the results of a 6-min walk test and a maximal isometric strength test for quadriceps femoral muscles in both legs) and the International Classification of Functioning, Disability and Health for classification of health and health-related domains.
Patient characteristics demonstrated a heterogeneous group: CR was started 44 ± 38.6 d after implantation; CR duration was 28 ± 9.7 d. Despite similar etiology, physical and psychological condition was diverse, although, overall a high degree of impairment was present, especially in the body function (79.7%) and activity and participation (95.7%) domains. The results demonstrated the need for a highly individualized approach in the somatic and also in the education, psychosocial, and social therapeutic regimes.
The results demonstrate a heterogeneous group with a high level of impairment and special needs in many CR domains. The development and evaluation of a special highly individualized approach of CR, which meets the special needs of these patients, is needed.
随着越来越多的左心室辅助装置（LVAD）的植入，需要制定满足这些患者特殊需求的充分心脏康复（CR）方案。仅有少数研究报告了这方面的经验。结构化 CR 策略的实施情况较差。本研究旨在评估更大队列中 LVAD 患者入院时的特征、治疗需求和范围，以确定他们特殊的 CR 需求。
回顾性单中心研究；纳入 69 名完成首次住院 CR 的 LVAD 患者（50.7±13.6 岁；59 名男性；48 名 HVAD；21 名 HeartMate II）。患者病历用于记录相关医学信息（包括 6 分钟步行试验和双腿股四头肌最大等长力量测试的结果）和国际功能、残疾和健康分类用于健康和健康相关领域的分类。
患者特征表现出异质性：CR 于植入后 44±38.6 天开始；CR 持续时间为 28±9.7 天。尽管病因相似，但身体和心理状况存在差异，尽管总体上存在高度的损伤，尤其是在身体功能（79.7%）和活动和参与（95.7%）领域。结果表明，需要在躯体以及教育、心理社会和社会治疗方案中采取高度个体化的方法。
结果表明，该组患者存在高度损伤和许多 CR 领域的特殊需求的异质性群体。需要制定和评估满足这些患者特殊需求的特殊高度个体化的 CR 方法。
