A Pilot Study in Transcatheter Aortic Valve Replacement Patients to Examine the Effects of Resistance Training and Protein Supplementation Through Telehealth.

Abstract

Background/objectives: Approximately 70% of transcatheter aortic valve replacement (TAVR) patients prior to TAVR have low muscle mass, increased mortality risk, and reduced quality of life (QoL) with little improvement in muscle mass and QoL after TAVR. Resistance training (RT) with protein supplementation is effective for maintaining and increasing muscle mass but has not been studied in TAVR patients. This study evaluated the effects of a 12-week telehealth program of RT combined with protein supplementation (RT + PRO; n = 11) versus PRO alone (n = 11) on body composition, inflammation, strength, physical function, and QoL in TAVR patients (75.7 ± 6.5 years; body mass index: 31.3 ± 6.4 kg/m2).

Methods: RT + PRO completed a RT program of 12 exercises, 2×/week, 8-15 repetitions, for 1-3 sets and consumed 75 g (37.5 g 2×/day) of whey protein. PRO consumed the same protein but did not exercise.

Results: There were no reported injuries. Adherence to the exercise and protein supplementation was greater than 90%. RT + PRO had greater improvements in strength (30-s chair stands: RT + PRO pre: 11 ± 3 vs. post: 13 ± 3; PRO pre: 12 ± 2 vs. post: 12 ± 3 repetitions; p = .003; time to complete five sit-to-stands: RT + PRO pre: 12.3 ± 3.8 vs. post: 9.6 ± 2.7; PRO pre: 11.2 ± 2.4 vs. post: 10.9 ± 2.9 s; p = .011) and QoL (Sarcopenia QoL Questionnaire: RT + PRO pre: 63.7 ± 12.9 vs. post: 74.0 ± 14.6; PRO pre: 69.7 ± 13.6 vs. post: 69.2 ± 16.1 points; p = .002).

Conclusions/implications: The telehealth exercise program was safe and well attended. The RT + PRO protocol significantly improved some measures of muscular strength and QoL in TAVR patients. A telehealth exercise program may serve as an alternative to traditional in person cardiac rehabilitation programs.