The utility of boxing for cardiac prehabilitation

Abstract

A 56-year-old man with end-stage heart failure performed a 4-week, symptom-limited, progressive inpatient cardiac prehabilitation program while confined to the cardiovascular intensive care unit awaiting heart transplantation. Mobility was limited by an acute gout flare and multiple central venous access lines. He received a tailored prescription of intermittent boxing, supervised hallway ambulation, stair training, and golfing on a putting green on four consecutive weekdays and was encouraged to mobilize with nursing on the remaining days. The patient progressed and by the last week demonstrated increased activity tolerance. He had a successful transplant after 40 days in the intensive care unit and was discharged with stamina sufficient to participate in outpatient cardiac rehabilitation, demonstrating the value, safety, and feasibility of an individualized inpatient cardiac prehabilitation program for patients with advanced cardiac disease medically confined to the intensive care unit.

Keywords:

• Boxing
• congestive heart failure
• heart transplantation
• inpatient cardiac rehabilitation
• prehabilitation
• specificity of training

ACKNOWLEDGMENTS

The authors extend special thanks to the cardiovascular ICU staff on the fourth floor of Roberts Hospital at Baylor University Medical Center for their support and guidance in the treatment of this patient; to Rey Perez, the boxing instructor at the Walter I. Berman Cardiovascular Prevention and Rehabilitation Center, for his time and expertise; and to Briget Da Graca for her invaluable medical writing and editing contribution.