Dilated cardiomyopathy and physical therapy dealing, challenges & recommendation: A tertiary care facility experience

Abstract

Takroni A Mohammed

Case presentation: A case of A 19-year-old male with Cardiomyopathy (DCM) and Ejection fraction (EF): <10%. Due to rapid deterioration and loss of weight, reduced muscle mass he developed cachexia and hypo-perfusion of several organ systems. This patient was supported by extracorporeal membrane oxygenation (ECMO), a month later a heart transplantation surgery was done. Strengthening, function and balance exercises were needed to be initiated prior to Aerobic Exercise (A/E) in cachexic patients. Intervention: Gradual therapeutic exercises, functional training, aerobic exercise, pelvic core muscle and strengthening exercise (Leg press machine).

Outcome measures: Six minutes�?? walk test1 and the SF-36 questioner2. All outcomes were measured in three stages (baselines, post 6 months and after one year).

Results: All outcome measures showed clinically significant improvement post 6 months and after one-year P<0.05.

Discussion: 30%, 48% of Patient diagnosed with DCM was with symptoms of heart failure. It has been proven that aerobic and resisted exercises are the most effective type of treatment protocols for patient with DCM3. However, the challenges in the current case found to be with post ECMO complication, cachexia (patient weight was 37 Kg, BMI was 15.9kg/m2) and high level of depression and lack psychosocial support among the Saudi population diagnosed with DCM and under gone heart transplantation surgery. Special consecrations must be taken in developing exercise prescription program for those patients.

Conclusion: Cardiac rehabilitation program of DCM patients�?? need gradual progression, should include strengthening, and function training prior to A/E including leg press machine as an essential part of the program that facilitate the muscle core of those patients. High level of psychosocial support is needed to over-come the anxiety and depression level which consequently improved well-being and quality of life.

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