What does this research mean for the field?

Early guided eccentric training after transcatheter aortic valve implantation (TAVI) is feasible but does not improve short-term functional mobility or the proportion of patients able to perform center of pressure tests compared to standard care. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aimed to assess the feasibility of eccentric training after TAVI and its impact on functional mobility.

February 27, 2026Open Access

Early Post-TAVI Physical Activity After Eccentric Training Compared to Standard Practice – Results of a Feasibility Study

Q: What is the clinical evidence from this study?

Study design: Other. Population: severe symptomatic aortic stenosis undergoing elective transcatheter aortic valve implantation (TAVI) (n=54). Intervention: early guided eccentric training vs. standard care (no structured or supervised exercise program). Primary outcome: proportion of patients performing the center of pressure (CoP) test on day 2-5 after TAVI (p=0.413).

Key Result

Early guided eccentric training after TAVI was feasible but did not improve the proportion of patients performing the center of pressure test compared to standard care (44.0% vs 55.2%, p=0.413).

Key Points

The study aimed to assess the feasibility of eccentric training after TAVI and its impact on functional mobility.
Conducted an interventional controlled feasibility trial
Enrolled elective TAVI patients with no severe mobility limitations
Compared measurements of functional mobility (CoP, TUG, CRT) before and five days after TAVI
Intervention group received daily 10-minute guided eccentric training; control group received standard care.
Of 357 screened patients, 54 participated in the study.
Eccentric training group needed significantly less handrail support during two-leg CoP compared to controls (4.2% vs 31.0%, p=0.015).
Physical SF-12 score improved more in controls than in the eccentric training group (+8.9 vs +1.6 points, p=0.022).

Structured PICO

Does daily 10-minute guided eccentric training improve physical performance and functional mobility in elderly patients early after TAVI compared to standard care?

Population

54 elderly patients with severe symptomatic aortic stenosis undergoing elective TAVI without severe mobility limitations, median age 81, 53.7% female, single-center (Germany). Exclusions: urgent or emergency TAVI, acute infections, illnesses for which physical activity is not indicated, or if attending physician did not recommend participation.

Intervention

Daily 10-minute guided eccentric training (four exercises with 2-3 sets of 10-15 repetitions each, focusing on trunk and lower extremity) starting earliest on day two post-TAVI until the day of hospital discharge.

Comparator

Standard care consisting of routine postoperative management including encouragement to sit up in bed, mobilize as tolerated, and walk according to clinical judgement as soon as possible, with no structured or supervised exercise program.

Outcome

Physical performance (measured as proportion of patients performing the center of pressure (CoP) while standing test) at day two to five after TAVI.surrogate

Initiating eccentric training within the first few days after TAVI is feasible but faces considerable barriers and does not provide short-term functional or quality-of-life benefits over standard care.

Main Result

Absolute Event Rate: 44% vs 55.2%

p-value: p=0.413

Limitations

Single-center, non-randomized sequential design with standard care enrolled first and intervention later, potentially introducing temporal confounding.
Small sample size and feasibility study design limits statistical power to detect differences.
High proportion of eligible patients declined participation, reducing generalizability.
Short duration and moderate intensity of exercise limited potential effects.
Baseline imbalances and moderate baseline functional status may have limited detectable improvements.
Majority of patients needed assistance for mobility tests limiting sensitivity to detect change.
Intervention could only be started after post-op day 3 in 72% of intervention patients and exercises were not fully completed within 10 minutes.

Abstract

Background: Physical activity after transcatheter aortic valve implantation (TAVI) can improve cardiovascular outcomes and health-related quality of life. The aim of the study was to evaluate the functional status before and shortly after TAVI and to test the feasibility of an eccentric training program and its effect on functional mobility compared to standard care. Methods: In this interventional controlled feasibility trial, elective TAVI patients without severe mobility limitations were enrolled. The center of pressure (CoP) measurements in standing position, the Timed Up the SF-12 test and the EuroQol– 5 Dimension test was calculated. The intervention group performed daily 10-minute guided eccentric training starting earliest on day two after TAVI; controls received standard care (no structured or supervised exercise program). Results: Of 357 screened patients, 99 met inclusion criteria; 45% declined to participate; 54 patients participated (median age 81 78– 83, 53.7% female). Orthopedic disorders were common (51.9%), as was chronic joint disease (18.5%). Before TAVI, most patients in both groups completed CoP testing. Fewer patients in the eccentric group required handrail support for the two-leg CoP test than controls (4.2% vs 31.0%, p=0.015). After TAVI, similar proportions in both groups completed the single-leg COP test (44% vs 51.7, p=0.389), all needing assistance. After day three, the intervention could be started in 72% of patients. None of those patients were able to complete all four exercises within 10 minutes No group differences were observed for TUG and CRT results (all p> 0.15). The physical SF-12 score improved more in controls (+8.9 points 25.-75. percentiles − 2.7– 14.9, p=0.022) compared to patients receiving eccentric training (+1.6 − 4.9– 9.5, p=0.463). Conclusion: Elderly TAVI patients showed limited functional mobility pre- and early post-procedure. Initiating eccentric training within the first few postoperative days was feasible but associated with considerable barriers and might not provide short-term functional benefit compared with standard care. Early activity after TAVI remains challenging within fast-track recovery pathways. Keywords: physical activity, TAVI, eccentric, mobility, feasibility

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Cite This Study

Haase-Fielitz et al. (Sun,) conducted a other in severe symptomatic aortic stenosis undergoing elective transcatheter aortic valve implantation (TAVI) (n=54). early guided eccentric training vs. standard care (no structured or supervised exercise program) was evaluated on proportion of patients performing the center of pressure (CoP) test on day 2-5 after TAVI (p=0.413). Early guided eccentric training after TAVI was feasible but did not improve the proportion of patients performing the center of pressure test compared to standard care (44.0% vs 55.2%, p=0.413).

synapsesocial.com/papers/69a134fbed1d949a99abe672 https://doi.org/https://doi.org/10.2147/cia.s563908

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