Key result
A 12-day interval exercise program safely increased the 6-minute walk test distance by 64 meters (from 144 to 208 meters) in a patient hospitalized with acute decompensated heart failure on continuous dobutamine therapy.
Why the study?
Does exercise training improve functional outcomes in a patient with acute decompensated heart failure receiving continuous inotropic therapy?
Case Report (n=1)
Does exercise training improve functional outcomes in a patient with acute decompensated heart failure receiving continuous inotropic therapy?
Exercise training can be safely and effectively implemented in a hospitalized patient with acute decompensated heart failure receiving continuous inotropic therapy, leading to functional improvements.
Should not yet change practice in ADHF on inotropes; hypothesis-generating for exercise training in this population.
BACKGROUND AND PURPOSE: The projected increase in persons with advanced heart failure and associated costs warrant the examination of exercise in patients receiving inotropic therapy. Literature supports the use of exercise and inotropic therapy in the treatment of patients with advanced heart failure. The purposes of this paper are to illustrate the use of exercise prescription and outcomes assessment with a 6-minute walk test in a patient with acute decompensated heart failure receiving tailored therapy with dobutamine and to discuss potential relationships resulting in observed improvements. CASE DESCRIPTION: A 67-year old man was admitted to an acute care hospital with acute decompensated heart failure for tailored medical therapy including dobutamine. The patient received 14 days of tailored medical therapy, of which 12 days included exercise training by a physical therapist. OUTCOMES: Functional outcomes showed a clinically significant improvement in distance walked and improvement in the cardiorespiratory response. The improvement in estimated peak oxygen consumption was 7% greater than that predicted to be from tailored medical therapy. DISCUSSION: Exercise was safely provided to a patient hospitalized with advanced heart failure on continuous inotropic therapy. The 6-minute walk test was effectively used to prescribe exercise and examine patient outcomes.
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Ricard et al. (2011) conducted a case report in Acute Decompensated Heart Failure (n=1). Interval exercise training program was evaluated on 6-minute walk test (6MWT) distance (64 meters increase). A 12-day interval exercise program safely increased the 6-minute walk test distance by 64 meters (from 144 to 208 meters) in a patient hospitalized with acute decompensated heart failure on continuous dobutamine therapy.
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