Open Access
Review

Table 1

Characteristics of the included studies.

Authors Moreno et al. Kerrigan et al. Scaglione et al. Alvarez Villela et al. Schmidt et al. Marko et al Schmidt et al
Year of publication 2020 2014 2021 2020 2018 2021 2017
Number of patients Total participants n = 22 Total participants n = 26 Total participants n = 50 Total participants n = 12 Total participants n = 10 “Total participants n = 41 patients with LVAD” Total participants n = 68 patients with LVAD
Distributed in: Control group n = 8 (1 does not complete the program); CR Group n = 18 of which 16 complete training.
Intervention duration 13 weeks, 3 times per week 6 weeks, Frequency: 3 times a week. In both groups, follow-up calls were made in week 2, 4, and 6 (new signs or symptoms, medications, hospitalizations). Hospitalization period (T0): from 15 to 62 days, approximately 4 weeks in-hospital. Discharge Time (T1) 2 sessions a day for 6 days a week. 15 sessions 5 weeks Duration: 3 weeks, 22 days and each session corresponded to 30 min. Duration: 32 ± 6 days of rehabilitation Duration: 3–5 weeks
Follow-up of 482 days after device implantation.
Training description HIIT Group MICT Group CR Group LVAD Group n = 25 HTx Group n = 25 HIIT Group Interval training: Bicycle, at the beginning of the CR average of 10/25 W at the beginning of the CR and at the end to an average of 14/36 W. MMII Strength Training Aerobic training Treadmill MMII Muscle Endurance Training
Training description They carried out an evaluation at the beginning and at the end of the program with a 6-minute walk test. Training 4 sets of 4 min with intensity of 80%–90% VO2 alternating with 3 min lower intensity 50%–60% VO2. Carry out evaluation at the beginning and end of the program with a 6-minute walk test. Training for 28 continuous minutes with a reserve of 50%–60% VO2. Physical training of 18 sessions of aerobic exercise between 60% and 80% of the HR reserve. It included walking on a treadmill, stationary bicycle, arm ergometer, recumbent stepper) 30 min at 60% of HR max 80%. Initial evaluation 6MWT, Heart Rate and Borg. HTx group: They underwent the same CR program as LVAD patients Each training session lasted 30 min: 3 min warm-up and six 30-s high-intensity intervals, each followed by a 4-min active recovery period. Bicycle, at the beginning of the RC average 10/25 W at the beginning of the RC and at the end up to an average of 14/36 W. MMII strength training: Leg press, leg extensor, leg flexor, lower limb abductor, lower limb adductor, 2 sets of 12 repetitions each. Aerobic training: Bicycle ergometer, 3-minute intervals of cycling without load at the beginning and end of the session to warm up and cool down. Hikes: Trails that covered different distances and elevations in different periods of time. Frequency: 5 and 7 days per week.
Interval training (Bicycle/treadmill) and progression to continuous exercise 40 min per session. For the first three sessions (“induction phase”), the prescribed workloads were 40% PPO warm-up, 80% PPO intervals, and 30% PPO cool-down periods. Resistance exercise was especially focused on muscular endurance.
Lower extremity training (3 sets of 20 repetitions) using medical exercise machines (e.g., leg curl, leg extension, and leg press) or small exercise tools (e.g., theraband and dumbbells).
Strength training: 1 set of 12 repetitions of 5 muscle groups MMSS and MMII. Aerobic exercises: walking and/or cycling 60–70% of the maximum oxygen consumption measured in the stress test. Respiratory exercises: Respiratory incentive. Workloads were increased in the fourth training session to 50% PPO warm-up, 100% PPO high-intensity intervals, and 40% PPO recovery periods. Gymnastic training: coordination, strength and balance training. Ergotherapy (if necessary) and exercise therapy (including resistance training on a bicycle ergometer) were generally performed 3–5 days per week.
The monitored bicycle training in most cases was performed using the interval method with 20 s of high intensity tracking followed by 40 s of low intensity.
Post-intervention changes Carry out evaluation at the beginning and end of the program with a 6-minute walk test. Training for 28 continuous minutes with a reserve of 50%–60% VO2 Improvement in treadmill stress test from 7.9 to 11.0 min. “There were no significant differences in T0 and T1 at 6MWT in patients with VADI and HTX Improvement in V̇O2 at the ventilatory threshold of 7.1 to 8.5 ml/kg/min. Visit 1: 6MWT walking distance > 367 to 449 meters. VO2 max 10.0 to 11.9 ml/kg/min. Maximum load increased from 62.4 to 83.0 W. Handgrip strength test from 29.2 to 34.7 kg without statistically significant changes Muscular strength in all trained muscle groups 26.6 ± 11.9 kg 33.6 ± 15.2 in leg press Improvement in the intensity of the bicycle ergometer: 2.0 ± 1.9 vs. 6.2 ± 2.8 VO2 increase 11.3 ± 4.1 ml/min/kg vs. 14.5 ± 5.2 “6-minute walk distance was significantly improved during CR (325 ± 106 to 405 ± 77 m; P < 0.01).
Oxygen consumption of 13.6 to 15.3 ml/kg/min. Changes were evident in:
  • HB: 10.2–10.8

  • Average corpuscular volume: 89–89.8

  • Creatinine: 0.85–0.99

  • Red blood cells: 3.59–3.66

LV end-diastolic volume 159–168 ml The average maximum workload achieved was 62.2 ± 19.3 W (38% of predicted values).
Improvement in 6MWT 350.1 ± 64.7 to 402.4 ± 89.3 Mean cardiopulmonary exercise capacity (relative maximal oxygen consumption) was 10.6 ± 5.3 ml/kg/min (37% of predicted values).

Abbreviations: n: Number of participants, HIT Group: High Intensity Interval Training, MICT: Moderate Intensity Continuous Training, VO2 Peak: Maximum Oxygen Consumption, CR: Cardiac Rehabilitation, HR: Heart Rate, 6MWT: 6 Minute Walk, T0: Functional and psychological tests at admission, T1: Functional and psychological tests at discharge, LVAD Group: Left Ventricular Assist Device, HTX Group: Heart Transplant Patients, LVAD: Left Ventricular Assist Device, VADI: Assist Device left ventricular, HB: Hemoglobin, PPO: Maximum power output, VI: Left ventricle, W: Watts, Mts: Meters, MMII: Lower limbs.

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