Dimitrova A1, Koleva Z2, Grigorova-Petrova K1, Lubenova D1, Nikolova M1
1National Sports Academy ' V. Levski', Physiotherapy and Rehabilitation, Sofia, Bulgaria, 2Acibadem City Clinic, Cardiology Center, Sofia, Bulgaria
Background: Transcatheter aortic valve implantation (TAVI) is an alternative intervention mainly for elderly patients with contraindications to surgical aortic valve replacement. Cardiac rehabilitation is a well established therapeutic approach for people with cardiac disease. Regular physical activity is an essential part of treatment in geriatric patients. It demonstrates preventative and therapeutic effects on many chronic conditions. Patients after TAVI, are candidates for referral to exercise-based patient centered physical therapy (PT). A lot of them a month after TAVI have limited functional abilities or complains. Comorbidities should be taken into consideration in the assessment of patients attending PT to ensure a better treatment plan. Physical therapy could benefits the independency for daily life activities and participation in socio-cultural life.
Purpose: The present study aims to evaluate the effect of 3-months physical therapy on functional recovery in patients after TAVI.
Methods: Twenty-one patients (10 male, 11 female; mean age 77,6±4,3; NYHA classes III-IV) were referred for in-hospital PT in Acibadem City Clinic Cardiovascular Center,and after discharge at home based self-monitored PT. Inclusion criteria were: all TAVI patients above the age of 70; male or female; signed informed consent. Exclusion criteria were: unstable clinical condition - according to treating physician; handicap before the procedure; recent stroke; decompensate diabetes mellitus type II; severe cognitive decline.
Subjects were followed up for 3 months and reassessed four times to evaluate their functional abilities through Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale (CIRS), spirometry, inspiratory capacity (IC), six minutes walking test (6 MWT), Borg scale, dynamometry, Barthel index (BI) and five times sit to stand (FTSTS).
Results: All the patients had significant improvement in physical tolerance (p 0,001), activities of daily living (p 0,01), respiratory function (p 0,01), grip strength for the right dominant hand (p 0,01) and lower limb muscle strength (p 0,05) after three months of physical therapy. The symptoms of depression and dyspnea also decreased significantly (p 0,001).
Conclusion(s): The applied PT program could benefit the physical activity and independence in patients after TAVI.
Implications: The authors' intention is to educate the PT students and the PT specialists in the application of the goal-oriented individually tailored physical therapy program in polymorbid elderly patients after TAVI in Bulgaria.
Keywords: physical therapy, elderly, TAVI
Funding acknowledgements: The present work was supported by the Acibadem City Clinic Cardiovascular Center, Sofia, Bulgaria
Purpose: The present study aims to evaluate the effect of 3-months physical therapy on functional recovery in patients after TAVI.
Methods: Twenty-one patients (10 male, 11 female; mean age 77,6±4,3; NYHA classes III-IV) were referred for in-hospital PT in Acibadem City Clinic Cardiovascular Center,and after discharge at home based self-monitored PT. Inclusion criteria were: all TAVI patients above the age of 70; male or female; signed informed consent. Exclusion criteria were: unstable clinical condition - according to treating physician; handicap before the procedure; recent stroke; decompensate diabetes mellitus type II; severe cognitive decline.
Subjects were followed up for 3 months and reassessed four times to evaluate their functional abilities through Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Cumulative Illness Rating Scale (CIRS), spirometry, inspiratory capacity (IC), six minutes walking test (6 MWT), Borg scale, dynamometry, Barthel index (BI) and five times sit to stand (FTSTS).
Results: All the patients had significant improvement in physical tolerance (p 0,001), activities of daily living (p 0,01), respiratory function (p 0,01), grip strength for the right dominant hand (p 0,01) and lower limb muscle strength (p 0,05) after three months of physical therapy. The symptoms of depression and dyspnea also decreased significantly (p 0,001).
Conclusion(s): The applied PT program could benefit the physical activity and independence in patients after TAVI.
Implications: The authors' intention is to educate the PT students and the PT specialists in the application of the goal-oriented individually tailored physical therapy program in polymorbid elderly patients after TAVI in Bulgaria.
Keywords: physical therapy, elderly, TAVI
Funding acknowledgements: The present work was supported by the Acibadem City Clinic Cardiovascular Center, Sofia, Bulgaria
Topic: Cardiorespiratory
Ethics approval required: No
Institution: 1. Acibadem City Clinic 2.National Sports Academy
Ethics committee: 1. Acibadem City Clinic 2.National Sports Academy
Reason not required: All procedures performed in the present study were in accordance with the international principles and the ethical standards of the Research and Ethics Committee of the the Acibadem City Clinic Cardiovascular Center, Sofia, Bulgaria and of the National Sports Academy, Sofia, Bulgaria. Both of them ensure the management and the monitoring of the participants. All the patients had signed informed consent statement and been given verbal explanation and instructions before starting the PT sessions.
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