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physioscience 2018; 14(01): 34-40
DOI: 10.1055/s-0044-100542
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Successful Rehabilitation of a 22-Year-Old Outpatient after Heart Transplantation with Severe Complications

Case ReportErfolgreiche Rehabilitation eines 22-jährigen ambulanten Patienten nach Herztransplantation mit schwerwiegenden KomplikationenFallbericht
Michel Kandel
Further Information

Publication History

24 January 2017

19 June 2017

Publication Date:
06 March 2018 (online)

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Abstract

Background There is a consensus that exercise therapy is an important component in patient rehabilitation after heart transplantation (HTX). Recent studies showed that intensive interval training is more effective than low to moderate intensity training. Several studies described reinnervation of both the para- and sympathetic nervous system. The consequences of these findings have, however, not been implemented and up-to-date guidelines on exercise prescription in HTX do not exist. Furthermore, in clinical practice comorbidity and negative side-effects can aggravate the rehabilitation process after HTX.

Objective This case report describes a successful individual rehabilitation programme.

Method After an orthotope HTX A 22-year-old male patient suffered from severe complications with a cerebrovascular accident causing a hemiplegia and an acute both-sided renal failure. Massive restrictions in daily activities due to physical, social and psychological factors became apparent. Although these factors affected the rehabilitation process, they did not inhibit the successful application of an intensive interval exercise programme.

Results/Conclusions Despite massive initial restrictions the patient well tolerated a consequent exercise therapy programme consisting of high intensity training and attained independency and a better quality of life level.

Zusammenfassung

Hintergrund Es besteht Einigkeit darüber, dass Übungstherapie ein wichtiger Bestandteil der Rehabilitation von Patienten nach Herztransplantation (HTX) ist. Neuere Studien zeigten, dass intensives Intervalltraining effektiver ist als geringes bis moderates Intensitätstraining. Mehrere Studien beschrieben die Reinnervation des para- und sympathischen Nervensystems. Die Konsequenzen dieser Ergebnisse wurden jedoch nicht umgesetzt, und aktuelle Leitlinien zur Verordnung von Training bei HTX liegen nicht vor. Außerdem können Komorbidität und negative Nebeneffekte in der klinischen Praxis den Rehabilitationsprozess nach HTX erschweren.

Ziel Dieser Fallbericht beschreibt ein erfolgreiches individuelles Rehabilitationsprogramm.

Methode Nach einer orthotopen HTX litt ein 22-jähriger Patient unter schwerwiegenden Komplikationen mit einer zerebrovaskulären Episode, die eine Hemiplegie und ein akutes beidseitiges Nierenversagen auslöste. Massive Einschränkungen in täglichen Aktivitäten aufgrund physischer, sozialer und psychologischer Faktoren traten auf. Obwohl diese Faktoren das Rehabilitationsprogramm beeinflussten, verhinderten sie nicht die Anwendung eines erfolgreichen intensiven Intervall-Trainingsprogramms.

Ergebnisse/Schlussfolgerung Trotz massiver Einschränkungen zu Beginn, hielt sich der Patient an ein konsequentes Übungstherapieprogramm einschließlich hoch intensives Training und gewann an Unabhängigkeit und besserer Lebensqualität.

Key words

heart transplantation - physiotherapy - rehabilitation - exercise

Schlüsselwörter

Herztransplantation - Physiotherapie - Rehabilitation - Übungen
 

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