Physical Therapy for a Child Poststroke With a Left Ventricular Assist Device

Area of Science:

• Pediatric rehabilitation
• Neurology
• Cardiology

Background:

• A 10-year-old boy with congenital heart disease awaiting transplant experienced a stroke, resulting in right hemiplegia.
• The patient required an external, portable left ventricular assist device (LVAD) for circulatory support during rehabilitation.

Observation:

• Standard physical therapy (PT) examinations and interventions were adapted for the patient with an LVAD.
• Exercise response was monitored through observation due to the inability to measure vital signs.
• Impairments included muscle tone, balance deficits, and reduced endurance, impacting functional mobility.

Findings:

• The patient tolerated intensive, individualized PT sessions.
• Improvements were noted in muscle tone, balance, and endurance.
• Functional mobility, including ambulation distance, speed, and independence, significantly improved by discharge.

Implications:

• This case demonstrates the successful application of PT in a complex pediatric patient with a stroke and LVAD.
• Close monitoring and adaptive strategies are crucial for effective rehabilitation in similar cases.
• Intensive PT can lead to substantial functional gains in children with significant medical complexities.