{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T03:23:45Z","timestamp":1767842625519,"version":"3.49.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018204","name":"Japanese Association of Cardiac Rehabilitation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100018204","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>There is no established method for early bed rehabilitation of patients after cardiogenic shock (CS) who require mechanical circulatory support (MCS). This study aimed to evaluate the safety of early upper limb extremity ergometer exercise in critically ill patients with CS or at risk for CS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was conducted as a prospective, single-center feasibility and observational study. Patients with CS or at risk for CS in the cardiac intensive care unit were enrolled. Upper limb extremity ergometer exercise was performed with alternating intervals of exercise and rest, in parallel with the rehabilitation program focused on early mobilization. A multidisciplinary team was established to determine the criteria for exercise initiation and cessation. Endpoint measures included exercise-related adverse events (circulatory or respiratory failure requiring new medical intervention, inability to continue device support, bleeding requiring hemostatic treatment at the insertion site, and exercise-related skeletal pain), vital signs, and subjective symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty-seven sessions in 28 patients (71 \u00b1 15 years, 75% male) were included in the analysis. MCS was used in 86% of the patients, and rehabilitation was initiated within 3 \u00b1 1 day. Two patients had temporary dyspnea, and none discontinued exercise. There was a significant increase in heart rate (p &amp;lt; 0.05) and respiratory rate (p &amp;lt; 0.001) during exercise compared with pre-excercise, but not in systolic or diastolic blood pressure and oxygen saturation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early upper limb extremity ergometer exercises for critically ill patients with CS or at risk for CS resulted in changes in heart rate and respiratory rate during exercise. However, no exercise-related adverse events occurred. Upper limb extremity ergometer exercise can be a new tool of physical therapy in the acute phase of patients after CS or at risk for CS.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2025.1448647","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T07:11:11Z","timestamp":1743145871000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility and safety of upper limb extremity ergometer exercise in the cardiac intensive care unit in critically ill patients with cardiac disease: a prospective observational study"],"prefix":"10.3389","volume":"16","author":[{"given":"Kotaro","family":"Hirakawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuko","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Arimitsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Kon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromichi","family":"Ueki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Hori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuki","family":"Ishimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayaka","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Higuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yumiko","family":"Hosoya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamoru","family":"Nanasato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuaki","family":"Isobe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"739","DOI":"10.1016\/j.jcin.2023.01.020","article-title":"Impella malrotation within the left ventricle is associated with adverse in-hospital outcomes in cardiogenic shock","volume":"16","author":"Baldetti","year":"2023","journal-title":"JACC Cardiovasc Interv."},{"key":"B2","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1002\/ccd.28329","article-title":"SCAI clinical expert consensus statement on the classification of cardiogenic shock: this document was endorsed by the American college of cardiology (ACC), the American heart association (AHA), the society of critical care medicine (SCCM), and the society of thoracic surgeons (STS) in April 2019","volume":"94","author":"Baran","year":"2019","journal-title":"Catheter Cardiovasc Interv."},{"key":"B3","first-page":"261","article-title":"Bestimmung von Schwellen der Herzfrequenzvariabilit\u00e4t bei Koronarsportlern - Eine Alternative zur Belastungssteuerung. 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