Home-Based Cardiac Rehabilitation (HBCR) In Post-TAVR Patients: A Prospective, Single-Center, Cohort, Pilot Study
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BRIEF REPORT
Home-Based Cardiac Rehabilitation (HBCR) In PostTAVR Patients: A Prospective, Single-Center, Cohort, Pilot Study Gurjaspreet K. Bhattal
. Ki E. Park . David E. Winchester
Received: May 11, 2020 The Author(s) 2020
ABSTRACT Introduction: Cardiac rehabilitation after transcatheter aortic valve replacement (TAVR) safely improves exercise tolerance, functional independence, and quality of life. However, barriers such as transportation, cost, and limited access to rehabilitation programs prohibits participation. In 2010, the Veterans Affairs Medical Center (VAMC) started a 12-week home-based cardiac rehabilitation (HBCR) program at 13 sites around the country to increase participation by reducing such barriers. We present the findings of HBCR in post-TAVR patients from the VAMC in Gainesville, FL, USA. Methods: Fifty-nine patients who underwent TAVR between 2015 and 2018 at the Gainesville VA were offered HBCR. Forty-one patients enrolled, 28 completed the program, and 14
Digital features: To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12416336. G. K. Bhattal (&) K. E. Park D. E. Winchester University of Florida Health, Gainesville, FL, USA e-mail: [email protected]; [email protected] K. E. Park D. E. Winchester Malcom Randall Department of Veterans Affairs Medical Center, North Florida South Georgia VAMC, Gainesville, FL, USA
completed the surveys. We used various performance measures including Life’s Simple 7 survey, 6-min Walk (6-MW), Duke Activity Survey Index (DASI), and Short Form-36 (SF-36) health survey to assess the pre and post-HBCR changes in emotional, functional, and physical well-being of the patients. Results: Paired comparison of pre and postHBCR using Wilcoxon signed-rank test revealed a statistically significant difference in the pre and post-HBCR scores for DASI, DASI-Mets, and SF-36 physical functioning (p values 0.05, 0.034, and 0.016, respectively), suggesting an improvement in the patients’ physical functioning after participating in the HBCR program. Conclusions: In conclusion, our pilot study offers novel insight into the role of HBCR in improving physical health and well-being in post-TAVR patients while eliminating the barriers of transportation and access to cardiac rehabilitation programs. Keywords: Aortic valve replacement; Cardiac rehabilitation; Home-based cardiac rehabilitation; TAVR
Cardiol Ther
Key Summary Points Why carry out this study? Cardiac rehabilitation after TAVR has been well reported to safely improve exercise tolerance, functional independence, and quality of life. However, barriers such as lack of transportation and limited access to rehabilitation programs limit participation. To mitigate these barriers, the Veterans Affairs Medical System (VAMC) started a 12-week-long home-based cardiac rehab (HBCR) program in 2010. To investigate the benefit of HBCR, we assessed the functional status of 14 patients upon completion of HBCR after TAVR between 2015 and 2018 at NFSG VAMC. What was
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