Effect of long-term rehabilitation on takotsubo syndrome-induced severe intensive care unit-acquired weakness: a case report

[Purpose] To examine the effectiveness of acute and outpatient cardiac rehabilitation for severe intensive care unit (ICU)-acquired weakness. [Participant and Methods] A 79-year-old woman, diagnosed with takotsubo syndrome. A percutaneous catheter-based transvalvular left ventricular assist device was used from day 2 to day 8, extracorporeal membrane oxygenation from day 3 to day 9, and inotropic support from day 1 to day 15. The patient was weaned from the ventilator on day 59, transferred to another hospital on day 67, and discharged home on day 152. From days 16 to 65 and 177 to 262, she underwent inpatient rehabilitation and outpatient cardiac rehabilitation, respectively, at our hospital. [Results] After inpatient rehabilitation at our hospital, her Medical Research Council score improved from 16 to 46. In outpatient cardiac rehabilitation, her 6-minute walk distance improved from 385 to 473 m, and her Kansas City Cardiomyopathy Questionnaire score improved from 88.6 to 100. [Conclusion] The results suggest that acute rehabilitation can effectively improve muscle strength, whereas outpatient cardiac rehabilitation can effectively improve exercise tolerance and quality of life in patients with severe ICU-acquired weakness.