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

Purpose: To describe physical therapy (PT) examination and intervention during rehabilitation for a child poststroke with an implanted left ventricular assist device (LVAD). Key Points: A 10-year-old boy with a history of congenital heart disease awaiting heart transplant was admitted to a pediatric rehabilitation hospital with right hemiplegia, and an external, portable LVAD. This child participated in standard PT examination procedures and interventions with accommodations for the LVAD. Observation was used to evaluate exercise response because of inability to measure vital signs. At admission, impaired muscle tone, balance, and endurance contributed to limitations in functional mobility. By discharge, improvements were seen in all impairments and also in ambulation distance, speed, and independence. Conclusion: This child awaiting heart transplant with an LVAD was able to tolerate intensive individualized PT. With monitoring and adjustments to the plan of care, he demonstrated improvements in functional mobility.