(P166) JUMPSTART-TAVR PILOT: EVALUATION OF AN EARLY MOBILIZATION VIRTUAL EXERCISE MODULE POST TAVR

Background: Trans-catheter aortic valve replacement (TAVR) has evolved rapidly and most patients are discharged home the next day. To our knowledge, there are no existing protocols for a TAVR specific exercise mobilization program. JUMPSTART-TAVR is designed as a virtual, self-directed and tailored exercise program that includes a variety of low intensity stretches and exercise modules to improve the early mobilization of TAVR patients post discharge. The objective of this pilot was to assess the acceptability and feasibility of the index virtual exercise module.

METHODS AND RESULTS: The study was conducted at a regional cardiac centre in Southwestern Ontario. Consecutive outpatients, undergoing successful TAVR procedure with no vascular complications or need for pacemaker, ambulating routinely within 6 hours post-procedure, able to complete a modified Timed Up and Go (TUG) and 2 Minute Walk Test (2MWT) and discharged the next day post-procedure were included. Patients were contacted at 5 days by telephone to assess clinical recovery and were provided an electronic link to the exercise module. The module was accessed at home by participants on their personal devices. A follow-up phone call was done at day 14 to assess feedback and barriers. Ethics requirement was waived for the process. Amongst 67 patients undergoing TAVR between January 6, 2022 and April 12, 2022, 39 outpatients (mean age 79.7 years, male 29 (74.3%) were assessed. At discharge 28/39 (71.7%) were eligible and at 5 days, 17/28 (60.7%) agreed to participate and were provided the electronic link. At 14 days follow-up 9/17 (52.9%) participants responded that they had used the module. All had positive feedback and raised no safety concerns with the exercise module. Feedback from patients not using the module is summarized in Table 1.

Conclusion: TAVR participants who were eligible for early mobilization post-procedure, had a positive perception and usability of the index exercise module. Barriers identified such as concerns regarding process and ability will be used to inform refinements and future module design and implementation. Expansion of the program will include a series of modules with different exercise intensity levels to match patient needs.