Physiotherapy-Led Cardiac Rehabilitation Following Mitral Valve Replacement: A Case Report from a Resource-Limited Setting
DOI:
https://doi.org/10.54536/ajpehs.v4i2.8042Keywords:
Cardiac Rehabilitation, Functional Capacity, Mitral Valve Replacement, Physiotherapy Intervention, Rheumatic Heart DiseaseAbstract
To evaluate the effectiveness of a structured cardiac rehabilitation programme in a 61-year-old woman who underwent mechanical mitral valve replacement due to rheumatic heart disease, a comprehensive 40-day intervention spanning lung expansion techniques, airway clearance, progressive mobilization, resistance and aerobic training, patient education, nutritional advice, and psychosocial support was initiated from postoperative day one; consequently, the patient achieved clinically meaningful, complication-free improvements across all primary outcomes by day forty, demonstrated by a reduction in pain intensity from 6/10 to 2/10, an increase in six-minute walk distance from 160 m to 240 m, and a decrease in borg perceived exertion ratings from “somewhat hard” to “very light,” alongside marked enhancements in emotional wellbeing and health-related quality of life as evidenced by a reduction in hospital anxiety and depression scale scores for anxiety from 11 to 6 and depression from 8 to 3, as well as increases in the sf-36 physical component score from 32 to 42 and the mental component score from 45 to 52; ultimately, these multidimensional outcomes underscore that early, structured, and progressive cardiac rehabilitation contributes substantially to physical recovery, psychological improvement, and quality-of-life enhancement, thereby highlighting the profound clinical value of individualized physiotherapy in optimizing postoperative results, particularly within resource-limited settings where rheumatic heart disease remains heavily prevalent.
Downloads
References
Abubakar, I., Dalglish, S. L., Angell, B., Sanuade, O., Abimbola, S., Adamu, A. L., Adetifa, I. M. O., Colbourn, T., Ogunlesi, A. O., Onwujekwe, O., Owoaje, E. T., Okeke, I. N., Adeyemo, A., Aliyu, G., Aliyu, M. H., Aliyu, S. H., Ameh, E. A., Archibong, B., Ezeh, A., Gadanya, M. A., … Zanna, F. H. (2022). The Lancet Nigeria Commission: investing in health and the future of the nation. Lancet (London, England), 399(10330), 1155–1200. https://doi.org/10.1016/S0140-6736(21)02488-0
Agrawal, D. P., & Berry, A. K. (2023). Exercise-based cardiac rehabilitation in a resuscitated post-mitral valve replacement middle-aged woman: A case report. International Journal of Health Sciences and Research, 13(5), 216–222.
Aleksandrowicz, K. A., Aleksandrowicz, K. M., Witkowski, T. G., Kosowski, M., Kübler, P., Grześkowiak, K., Golański, G. P., Kulig, D. J., Rachwalik, M. F., Przybylski, R., Reczuch, K., & Protasiewicz, M. (2023). Early heart rate recovery after a 6-min walking test predicts clinical benefits in patients after percutaneous aortic valve implantation. International Journal of Environmental Research and Public Health, 20(5), 4270. https://doi.org/10.3390/ijerph20054270
Bartels, M. N., & Prince, D. Z. (2021). Acute medical conditions: Cardiopulmonary disease, medical frailty, and renal failure. In R. L. Braddom (Ed.), Braddom’s physical medicine and rehabilitation (6th ed., pp. 511–534.e5). Elsevier. https://doi.org/10.1016/B978-0-323-62539-5.00027-8
Bashir, S., Tariq, I., & Rauf, S. (2024). Discrepancy in cardiac rehabilitation: National and international perspective. The Rehabilitation Journal, 8(1), 1–2. https://doi.org/10.52567/trehabj.v8i01.59
Brocki, B. C., Thorup, C. B., & Andreasen, J. J. (2010). Precautions related to midline sternotomy in cardiac surgery: A review of mechanical stress factors leading to sternal complications. European Journal of Cardiovascular Nursing, 9(2), 77–84. https://doi.org/10.1016/j.ejcnurse.2009.11.009
Brown, T. M., Pack, Q. R., Aberegg, E., Brewer, L. C., Ford, Y. R., Forman, D. E., Gathright, E. C., Khadanga, S., Ozemek, C., & Thomas, R. J. (2024). Core components of cardiac rehabilitation programs: 2024 update: A scientific statement from the American Heart Association and the American Association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 150(18), e328–e347. https://doi.org/10.1161/CIR.0000000000001289
Deighan, C., Michalova, L., Pagliari, C., Elliott, J., Taylor, L., & Ranaldi, H. (2017). The Digital Heart Manual: A pilot study of an innovative cardiac rehabilitation programme developed for and with users. Patient Education and Counseling, 100(8), 1598–1607. https://doi.org/10.1016/j.pec.2017.03.015
Elnagar, I. M., Alghamdi, R., Alawami, M. H., Alshammari, A., Almedimigh, A. A., Albabtain, M. A., AlGhamdi, A., Ismail, H. H., Shalaby, M. A., Alotaibi, K. A., & Arafat, A. A. (2025). Long-term outcomes of mitral valve repair versus replacement in patients with ischemic mitral regurgitation: A retrospective propensity-matched analysis. Journal of Cardiovascular Development and Disease, 12(4), 109. https://doi.org/10.3390/jcdd12040109
Grace, S.L.; Taylor, R.S.; Gaalema, D.E.; Redfern, J.; Kotseva, K.; Ghisi, G. Cardiac Rehabilitation: A Global Perspective on Where We Have Come and Where We Must Go. JACC Adv. 2023, 2, 100412.
Grochulska, A., Bryndal, A., & Glowinski, S. (2025). The impact of early rehabilitation program on exercise tolerance in post-myocardial infarction patients: A 5-week intervention study. BMC Cardiovascular Disorders, 25(1), 542. https://doi.org/10.1186/s12872-025-04988-y
Haseen, M., Sethi, S. W., Wahab, A., & Ullah, H. (2026). Effects of group-based cardiac rehabilitation on coronary artery bypass surgery patients. The American Journal of Physical Education and Health Science (AJPHEs), 4(2).
Javed, N., Pineda, R., Itare, V., Ashraf, S., & Kamalakkannan, G. (2025). Rheumatic valve disease presenting as mitral stenosis and regurgitation. Cureus, 17(6), e86671. https://doi.org/10.7759/cureus.86671
Khan, N. N. (2026). Knowledge, Attitude and Practice about risk factors for cardiovascular diseases among university students in Dhaka, Bangladesh. American Journal of Medicine and Health Care (AJMHC), 1(1), 66-75.
Lavie, C. J., Menezes, A. R., De Schutter, A., Milani, R. V., & Blumenthal, J. A. (2016). Impact of cardiac rehabilitation and exercise training on psychological risk factors and subsequent prognosis in patients with cardiovascular disease. Canadian Journal of Cardiology, 32(10 Suppl 2), S365–S373. https://doi.org/10.1016/j.cjca.2016.07.508
Lee, J. Y. (2024). The history and overview of cardiac rehabilitation and secondary prevention. Journal of Cardiovascular Intervention, 3(3), 98–118. https://doi.org/10.54912/jci.2024.0003
Lupieri, A., Jha, P. K., Nizet, V., Dutra, W. O., Nunes, M. C. P., Levine, R. A., & Aikawa, E. (2025). Rheumatic heart valve disease: Navigating the challenges of an overlooked autoimmune disorder. Frontiers in Cardiovascular Medicine, 12, 1537104. https://doi.org/10.3389/fcvm.2025.1537104
Maruf, F. A., & Mohammed, J. (2023). Unmet needs for cardiac rehabilitation in Africa: A perennial gap in the management of individuals with cardiac diseases. High Blood Pressure & Cardiovascular Prevention, 30, 199–206.
Mueller, A. S., & Kim, S. M. (2025). Cardiac Rehabilitation in the Modern Era: Evidence, Equity, and Evolving Delivery Models Across the Cardiovascular Spectrum. Journal of Clinical Medicine, 14(15), 5573. https://doi.org/10.3390/jcm14155573
Myneni, P., Bodduluri, M., Gadde, S. T., Nimmagadda, R., Manvitha, M., Valiveti, S. C., Sahu, S., & Younas, S. (2024). Effectiveness of cardiac rehabilitation in enhancing clinical outcomes for coronary artery disease: A systematic analysis. Cureus, 16(9), e69224. https://doi.org/10.7759/cureus.69224
Ogah, O. S., Bode-Thomas, F., Yilgwan, C. S., Ige, O., Ogah, F., Ogunkunle, O. O., Okwuonu, C., & Sani, M. U. (2020). Rheumatic heart disease in Nigeria: A review. Nigerian Journal of Cardiology, 17(1), 27–36. https://doi.org/10.4103/njc.njc_30_19.
Perone, F., Loguercio, M., Sabato, F., Pasquini, A., Ostojic, M., Avagimyan, A., Sileikiene, V., Popiolek-Kalisz, J., Aleksova, A., & Ambrosetti, M. (2025). Cardiac rehabilitation after mitral valve intervention: Tailored assessment, management, and exercise training. Journal of Cardiovascular Development and Disease, 12(7), 265. https://doi.org/10.3390/jcdd12070265
Salik, I., Lee, L. S., Sharma, S., & Widrich, J. (2024). Mitral valve repair. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549879
Setlers, K., Jurcenko, A., Arklina, B., Zvaigzne, L., Sabelnikovs, O., Stradins, P., & Strike, E. (2024). Identifying early risk factors for postoperative pulmonary complications in cardiac surgery patients. Medicina, 60(9), 1398. https://doi.org/10.3390/medicina60091398
Sika-Paotonu, D., Beaton, A., Raghu, A., Steer, A., & Carapetis, J. (2017). Acute rheumatic fever and rheumatic heart disease. In J. J. Ferretti, D. L. Stevens, & V. A. Fischetti (Eds.), Streptococcus pyogenes: Basic biology to clinical manifestations. University of Oklahoma Health Sciences Center. https://www.ncbi.nlm.nih.gov/books/NBK425394/
Subih, M., Elshatarat, R. A., Sawalha, M. A., Almarwani, A. M., Alhadidi, M., Alrahahleh, M., & Al-Delaimy, W. K. (2024). Exploring the impact of cardiac rehabilitation programs on health-related quality of life and physiological outcomes in patients post coronary artery bypass grafts: A systematic review. Reviews in Cardiovascular Medicine, 25(4), 145. https://doi.org/10.31083/j.rcm2504145
Tang, Z., Wang, Z., & Wang, X. (2025). Global burden of pediatric rheumatic heart disease, 1990–2021: Analysis of the GBD 2021 study. Children, 12(7), 843. https://doi.org/10.3390/children12070843
Velidakis, N., Khattab, E., Gkougkoudi, E., & Kadoglou, N. P. E. (2023). Pulmonary hypertension in left ventricular valvular diseases: Pathophysiology and prognostic value. Life, 13(9), 1793. https://doi.org/10.3390/life13091793
Wall, H.K.; Stolp, H.; Wright, J.S.; Ritchey, M.D.; Thomas, R.J.; Ades, P.A.; Sperling, L.S. The Million Hearts Initiative: Catalyzing Utilization of Cardiac Rehabilitation and Accelerating Implementation of New Care Models. J. Cardiopulm. Rehabil. Prev. 2020, 40, 290–293
Zhang, R., Lan, X., Huang, P., Zhang, Y., Zhu, C., Tian, F., Chen, S., & Chen, Y. (2025). Exercise rehabilitation for patients undergoing interventional treatment for heart valve disease: A scoping review and evidence summary. BMC Nursing, 24, 950. https://doi.org/10.1186/s12912-025-03603-x.
Zhang, Y., Huang, S., Liu, B., & Li, Y. (2025b). Seize the advantages of cardiac rehabilitation. Annals of Medicine, 57(1), 2519680. https://doi.org/10.1080/07853890.2025.2519680
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Yakubu Abubakar, Abdulbaki Aminu
This work is licensed under a Creative Commons Attribution 4.0 International License.
