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Cardiac and Physical Rehabilitation 

Cardiac and Physical Rehabilitation
Chapter:
Cardiac and Physical Rehabilitation
Author(s):

Erik H. Van Iterson

and Thomas P. Olson

DOI:
10.1093/med/9780190909291.003.0045
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date: 27 May 2020

Cardiac and physical rehabilitation featuring exercise training (ET) is an important component of secondary prevention. Patients with advanced heart failure (HF) and dependent on mechanical circulatory support (MCS) who participate in cardiac and physical rehabilitation demonstrate physiological adaptations and improvements in exercise capacity and prognosis. Immediate post-implant and long-term engagement in ET works to strengthen central and peripheral oxygen-dependent metabolic pathways as a primary means for which clinical and real-world benefits are gained. Accordingly, this chapter presents (1) a contemporary review of the role that cardiac and physical rehabilitation plays in HF and MCS; (2) discussion focused on the importance of understanding exercise physiology as the basis for ET; (3) evidence-based recommendations for deploying safe and individualized ET in the immediate- to long-term postoperative window; and (4) identification of key research areas focused on MCS and secondary prevention needed to advance the mechanistic understanding of the benefit linked to ET, to gain universal support for cardiac and physical rehabilitation, and to improve patient utilization of cardiac and physical rehabilitation.

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