Early Post-TAVI Physical Activity After Eccentric Training Compared to Standard Practice - Results of a Feasibility Study.

Of 357 screened TAVI patients, only 54 ultimately participated in the study, with 45% of eligible patients declining to participate.

• 357 patients were screened; 99 met inclusion criteria
• 45% of eligible patients declined to participate
• 54 patients ultimately participated
• Median age was 81 years (IQR 78–83), and 53.7% were female

Orthopedic disorders and chronic joint disease were highly prevalent among enrolled TAVI patients prior to the procedure.

• Orthopedic disorders were present in 51.9% of enrolled patients
• Chronic joint disease was present in 18.5% of enrolled patients
• These comorbidities represent potential barriers to physical rehabilitation

Before TAVI, fewer patients in the eccentric training group required handrail support for the two-leg center of pressure (CoP) test compared to controls.

• 4.2% of the eccentric training group required handrail support vs 31.0% of controls
• This difference was statistically significant (p=0.015)
• This finding suggests baseline differences in balance/functional status between groups

After TAVI, similar proportions of patients in both groups completed the single-leg CoP test, with all requiring assistance.

• 44% of the eccentric training group vs 51.7% of controls completed the single-leg CoP test post-TAVI (p=0.389)
• All patients who completed the single-leg CoP test post-TAVI required assistance
• This indicates substantial functional limitation in the early post-TAVI period in both groups

Initiating the eccentric training intervention after day three was feasible in 72% of patients, but no patient was able to complete all four exercises within the 10-minute session.

• The intervention could be started in 72% of patients after day three post-TAVI
• None of the patients were able to complete all four exercises within 10 minutes
• The intervention group performed daily 10-minute guided eccentric training starting earliest on day two after TAVI

No significant group differences were observed for Timed Up & Go (TUG) or Chair-Rising Test (CRT) results between the eccentric training and control groups.

• All p-values for TUG and CRT comparisons were >0.15
• TUG assesses functional mobility; CRT assesses functional lower extremity muscle strength
• Tests were assessed before and within five days after TAVI

The physical component of the SF-12 health-related quality of life score improved significantly more in controls than in patients receiving eccentric training.

• Physical SF-12 score improved +8.9 points (25th–75th percentiles: -2.7 to 14.9) in controls (p=0.022)
• Physical SF-12 score improved only +1.6 points (25th–75th percentiles: -4.9 to 9.5) in the eccentric training group (p=0.463)
• The improvement in the eccentric training group was not statistically significant

Elderly TAVI patients demonstrated limited functional mobility both before and shortly after the procedure.

• Most patients required assistance for single-leg CoP testing after TAVI
• Functional assessments included CoP measurements, TUG, and CRT performed before and within five days after TAVI
• The authors note that 'early activity after TAVI remains challenging within fast-track recovery pathways'