Feasibility and short-term effectiveness of an additional resistance and balance training in cardiac rehabilitation for older patients after valve surgery: results of a pilot study

Abstract

Introduction: The number of surgically treated elderly patients with valvular heart disease (VHD) is increasing. This group of patients has special needs regarding exercise based cardiac rehabilitation (CR), but until now, only few CRstudies have focused on this group. Purpose: To evaluate the feasibility and shortterm effects of an additional resistance and balance training compared to usual care CRprogram, to improve functional capacity muscular strength and physical performance in patients after valve surgery or intervention. Methods: A pilot study of a prospective, singlecenter, randomized controlled trial carried out in inpatient CR setting. Inclusion criteria were: age =65 years, valve surgery or intervention, ability to start CR within 4 weeks postsurgery, 6minute walking distance (6MWD) =100= 350 m, written patient’s agreement. Patients (Pts) (N=29, 74,72±7,9 years, 51,7% female) were randomly stratified for gender assigned (1:1 ration) to intervention group (IG n=14) or control group (CG n=15). All pts completed comprehensive 3 week exercise based CR program including aerobic endurance training on cycle ergometer (30 min, 5 days/week), additional aerobic exercise (sitting or standing) (30 min, 5 day/week) and respiratory exercises ( 15 min, 7 days/week). Patients of the IG participated in additional exercise session 3 days/week including 15 min balance training and 30 min resistance training. Functional capacity and mobility using 6MWD the short physical performance battery (SPPB), frailty was assed using 5 meters walking test and muscular strength was assed by repetition maximum (1RM) for legpress. Patients were assed twice: before and after CR program. Results: At the beginning of CR no significant differences were observed between groups (age: IG 72.8±2 y. vs. CG 76.5±2.1 y., p=0.354; gender IG were 6 (40%) females vs. CG 9 (60%), p=0.464; 6MWD IG 239.3±28.6 m. vs. CG 242.3±32.1, p=0.906 [...].