Key result
Supervised exercise training significantly improved exercise capacity (SMD 0.735) and quality of life scores (SMD 1.58) in ambulatory patients with left ventricular assist devices compared to usual care.
Why the study?
Does supervised exercise training improve peak oxygen uptake and quality of life in ambulatory patients with left ventricular assist devices compared to usual care?
Systematic Review (n=205)
Does supervised exercise training improve peak oxygen uptake and quality of life in ambulatory patients with left ventricular assist devices compared to usual care?
Effect estimate: SMD 0.735 (95% CI 0.31-1.15)
p-value: p=0.001
Supervised exercise training is safe and significantly improves peak oxygen uptake and quality of life in patients with left ventricular assist devices compared to usual care.
Supports supervised exercise training in ambulatory LVAD care; strengthens evidence base via systematic synthesis.
Implantation of left ventricular assist devices (LVAD) has increased because of improved safety profile and limited availability of heart transplantation. Although supervised exercise training (ET) programs are known to improve exercise capacity and quality of life (QoL) in heart failure (HF) patients, similar data is inconclusive in LVAD patients. Thus, we performed a systematic review on studies that incorporated supervised ET and measured peak oxygen uptake in LVAD patients. A total of 150 patients in exercise and 55 patients in control groups were included from 8 studies selected from our predefined criteria. Our systematic review suggests supervised ET has an inconsistent effect on exercise capacity and QoL when compared to control groups undergoing usual care. A quantitative sub-analysis was performed with 4 studies that provided enough data to compare peak oxygen uptake and QoL at baseline and at follow-up. After at least 6 weeks of training, LVAD patients undergoing supervised ET demonstrated significant improvement in exercise capacity (standardized mean difference [SMD] = 0.735, 95% Confidence Interval-[CI], 0.31-1.15 units of the standard deviation, P = 0.001) and QoL scores (SMD = 1.58, 95% CI 0.97-2.20 units of the standard deviation, P <0.001) when compared to the usual care group, with no serious adverse events with exercise. These results suggest that supervised ET is safe and can improve patient outcomes in LVAD patients when compared to the usual care.
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Ganga et al. (2017) conducted a systematic review in Ambulatory patients with left ventricular assist devices (LVAD) (n=205). Supervised exercise training vs. Usual care was evaluated on Peak oxygen uptake (exercise capacity) (SMD 0.735, 95% CI 0.31-1.15, p=0.001). Supervised exercise training significantly improved exercise capacity (SMD 0.735) and quality of life scores (SMD 1.58) in ambulatory patients with left ventricular assist devices compared to usual care.
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