1000 Section - A case report of ultra-early rehabilitation after implantation of left ventricular assist device

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

WC

Weiguan Chen, MD

Director of Department of Rehabilitation Medicine
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)

Co-Author/Coautor(s)

DJ

Dianwang Jiang, BS

PT
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)
XW

Xichen Wang, MS

PT
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)
HL

Hongjian Lu, MD

President
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)
CD

Chengwei Duan, PhD

Postgraduate
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)
DZ

Di Zhu, BA

Postgraduate
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)
JL

Jun Lu, BA

Postgraduate
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)
SZ

Sanlian Zhou, BA

Head nurse
Nantong First People's Hospital affiliated to Southeast University
Nantong, Jiangsu, China (People's Republic)

Case Diagnosis: A 50-year-old male with hypertension and a history of acute extensive anterior myocardial infarction complicated by cardiogenic shock and cardiac arrest underwent LVAD implantation combined with left ventricular thrombectomy on April 6, 2024. Preoperative evaluation revealed global cardiac enlargement, left ventricular ejection fraction of 32%, and severe functional impairment due to post-anoxic encephalopathy sequelae.

Case Description: A multidisciplinary team comprising rehabilitation physicians, therapists, cardiac surgeons, and specialized nurses initiated a phased rehabilitation program on postoperative day 3. The protocol followed the Leuven University progressive critical care rehabilitation model, including passive joint mobilization (days 3-4), semi-recumbent lower extremity strength and cycle ergometer training (day 5), sitting training (day 6), standing (day 7), and walking exercises (day 8 onward). Exercise intensity was controlled at Rating of Perceived Exertion (RPE) 11-12, heart rate 50-70% of peak or < 120 beats/min, and mean arterial pressure 70-90 mmHg. Comprehensive assessments were conducted preoperatively and at postoperative days 2, 2 weeks, 4 weeks, and 6 weeks using lower extremity muscle strength grading, Holden Walking Function Classification, Six-Minute Walking Distance (6MWD), and Barthel Index.

Discussions: After 6 weeks of rehabilitation, lower extremity muscle strength improved from grade 3 to 4, Holden Walking Function Classification increased from level 1 to 3, 6MWD increased from 5 m to 184 m, and Barthel Index improved from 40 to 70 points. The patient achieved supervised independent walking and partial ADL independence. No adverse events occurred during training. At 2-month follow-up, the patient could independently walk 1000 m at 50 m/min without cardiopulmonary symptoms.

Conclusions: Early initiation of exercise-based rehabilitation following LVAD implantation is safe and effective in significantly improving motor function, exercise tolerance, and ADL capacity. Multidisciplinary collaboration and stringent safety monitoring are essential for successful implementation. This case provides valuable experience for establishing standardized early rehabilitation protocols for LVAD recipients.