Exercise-based real-time telerehabilitation for older patients recently discharged after transcatheter aortic valve implanta-tion:An extended feasibility study
摘要OBJECTIVES To assess the extended feasibility of a telerehabilitation program and its effects on physical performance in older adults who have recently undergone transcatheter aortic valve implantation(TAVI).METHODS In this single-center feasibility study,patients underwent an eight-week telerehabilitation program,involving web-based home exercise training twice weekly,an activity tracker,access to an informative website,and one online session with a nurse,starting one-week postoperative.Data collection was performed before surgery and three months postoperative.The feas-ibility of the intervention was based on recruitment and adherence to the program.As a secondary outcome,we evaluated the change in six-minute walk distance from before surgery to three months postoperative.RESULTS Forty-one patients scheduled for TAVI were assessed for eligibility;15 patients(37%)were enrolled.Of these,eight were excluded after surgery due to tiredness(n = 2),non-cardiac related hospital readmission(n = 2),fluctuating health(n = 1),death during hospital stay(n = 1),and reduced cognition(n = 2).Seven patients completed the eight-week web-based interven-tion and were evaluated three months postoperative.Their median(IQR)age was 83[81,87]years,and the sample comprised three men and four women.Their walked distance improved from median(IQR)262[199,463]before surgery,to 381[267,521]meters three months postoperative.No adverse events were reported.CONCLUSION Web-based telerehabilitation,including supervised exercise training,in older adults who have recently under-gone TAVI was feasible for a small number of patients who completed the eight-week intervention.This was reflected in an im-provement in their walked distance three months after the surgery.However,the low recruitment and retention rates do ques-tion the overall feasibility of this intervention in a frail,older population of post-TAVI patients.
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