Safety and effectiveness of oscillatory whole-body vibration training on exercise capacity and physical performance in aortic valve stenosis patients prior to transcatheter aortic valve implantation: a randomized clinical trial.

Abstract

Background: Exercise training is generally discouraged in patients with severe symptomatic aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI) due to safety concerns. However, whole-body vibration (WBV) exercise could offer a novel approach to improve exercise capacity and quality of life, though its effects remain unclear in this population.

Methods: Thirty patients with AS scheduled for TAVI were prospectively and randomly assigned to either the WBV group (12 sessions, 30 min each over 4 weeks) or a control group. Assessments of cardiopulmonary exercise testing (CPET), 6-min walking distance (6MWD) and health-related quality of life (HRQoL) questionnaires were conducted at baseline (V1), one day before TAVI (V2) and at short-term follow-up (V3). WBV was conducted between V1 and V2.

Results: For the analysis at V1 and V2 16 patients in the WBV group and 14 in the control group were included. Mean age was 79.7 ± 5.22 years, with a mean aortic valve area of 0.75 ± 0.21 cm². Peak V'O₂ increased by 0.3 mL*min^-1*kg^-1 in the WBV group versus a decrease of - 1.4 mL*min^-1*kg^-1 in the control group (difference, 1.7 mL*min^-1*kg^-1; 95% CI, [0.2 to 3.2], p = 0.03). Peak power improved by 5.1 W in the WBV group compared to a decline of - 4.5 W in the control group (difference, 9.6 W; 95% CI, [2.1 to 17.1], p = 0.01). The WBV group also showed a non-significant improvement in 6MWD (34 m vs. - 8 m in the control group; difference, 42 m; 95% CI, [-10 to 93], p = 0.11). No serious adverse events occurred in the WBV group.

Conclusion: This pilot study demonstrated that a WBV exercise program is feasible, safe, and showed potential to preserve exercise capacity as well as physical performance in AS patients scheduled for TAVI.