Corovic Marija, Mosleh Karen, Puglisi Olivia, Cameron Malcolm, Crawshaw Jacob, Styra Rima, Magloire Patrick, Schwalm Jon-David, Velianou James, Sheth Tej, Natarajan Madhu
Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.
Hamilton Health Sciences, King West, P.O. Box 2000, Hamilton, ON, L8N 3Z5, Canada.
BMC Cardiovasc Disord. 2025 Mar 25;25(1):216. doi: 10.1186/s12872-025-04665-0.
Patients with aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) are typically discharged from hospital the next day, leaving little time to support their mobilization needs. Therefore, to improve the early mobilization of post-TAVR patients, we investigated the adoption and acceptability of a self-directed, tailored and home-based exercise program (JUMPSTART), which consists of four exercise modules, available in virtual and paper formats.
This prospective, observational, non-randomized and comparative study was conducted at one regional cardiac centre in Ontario, Canada. The development of the JUMPSTART program was informed by the Knowledge-to-Action Cycle and the choice of study outcomes were guided by the RE-AIM Framework. Program adoption and acceptability were captured through two follow-up surveys, 14-days and three-months post-TAVR; survey questions were informed by the Consolidated Framework for Implementation Research. The target program adoption rate was 70% by three-months post-TAVR. Impact of program participation on quality-of-life scores, and study participants' cardiac rehabilitation attendance, were also assessed.
There were 144 study participants. Survey response rates were 86% at 14-days post-TAVR, and 78% at three-months post-TAVR. The program adoption rate was 75% while the cardiac rehabilitation attendance rate was 30%. Approximately 70% of participants preferred the paper-based program format. The technological requirement was the most common barrier to engaging with virtual formats. Most (70%) rated the exercises as being the right level of difficulty. There were no reports of major health or safety concerns while exercising. Quality-of-life scores significantly increased from baseline to three-months post-TAVR; however, this could not be attributed to frequency of program participation. Furthermore, 73% of program participants felt that their recovery was improved because of their participation in the program, and 96% reported that they would recommend it to others. The study team regularly reviewed preliminary findings and took action to improve the program and the implementation process.
Participants were satisfied with the JUMPSTART program, which will continue to be offered to post-TAVR patients. Despite the increasing use of virtual technologies, most of this patient population prefers paper-based resources. Future planning will involve developing additional modules and exploring ways to increase program adoption, as well as cardiac rehabilitation attendance.
Not applicable.
接受经导管主动脉瓣置换术（TAVR）的主动脉瓣狭窄患者通常在术后第二天出院，几乎没有时间满足他们的活动需求。因此，为了改善TAVR术后患者的早期活动能力，我们调查了一种自主导向、量身定制的居家锻炼计划（JUMPSTART）的采用情况和可接受性，该计划由四个锻炼模块组成，有虚拟和纸质两种形式。
这项前瞻性、观察性、非随机对照研究在加拿大安大略省的一个地区心脏中心进行。JUMPSTART计划的制定以知识转化行动循环为依据，研究结果的选择以RE-AIM框架为指导。通过TAVR术后14天和3个月的两次随访调查来了解计划的采用情况和可接受性；调查问题以实施研究综合框架为依据。目标是在TAVR术后3个月时计划采用率达到70%。还评估了参与该计划对生活质量评分的影响以及研究参与者参加心脏康复治疗的情况。
共有144名研究参与者。TAVR术后14天的调查回复率为86%，术后3个月为78%。该计划的采用率为75%，而心脏康复治疗的参与率为30%。约70%的参与者更喜欢纸质版的计划形式。技术要求是参与虚拟形式的最常见障碍。大多数（70%）参与者认为锻炼难度适中。锻炼期间未报告重大健康或安全问题。从基线到TAVR术后3个月，生活质量评分显著提高；然而，这不能归因于计划参与的频率。此外，73%的计划参与者认为参与该计划改善了他们的康复情况，96%的参与者表示会向他人推荐该计划。研究团队定期审查初步结果，并采取行动改进该计划和实施过程。
参与者对JUMPSTART计划感到满意，该计划将继续提供给TAVR术后患者。尽管虚拟技术的使用越来越多，但大多数这类患者更喜欢纸质资源。未来的规划将包括开发更多模块并探索提高计划采用率以及心脏康复治疗参与率的方法。
不适用。
