Barriers and facilitators to physical activity after transcatheter aortic valve replacement: A mixed-methods study.
Zhiyun Shen, Xiaojue Qian, Chenxu Huang and 5 others
PMID 39988751WHAT IT FOUND
Most TAVR patients remained physically inactive after valve replacement.
Regular prior exercise, post-discharge professional support, and less discomfort were linked with activity. Fear, misconceptions about daily tasks, distance, and lack of guidance blocked many.
Key findings
01Only 13 of 195 TAVR patients had appropriate physical activity levels, while 182 remained physically inactive.
02In multivariable analysis, exercising at least 3 times per week before TAVR and receiving physical activity support after discharge were linked with being physically active, while self-reported discomfort was linked with being inactive.
03Almost all interviewees said they lacked professional advice on physical activity after TAVR, and guidance from doctors or nurses during follow-up helped them persist.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Physical activity and discomfort were self-reported, so recall and information bias could affect the results. The study was a single-centre survey in Shanghai, so the barriers and facilitators may not apply to other health systems or countries. The design was cross-sectional and interview-based, so it can show links but cannot prove that prior exercise, professional support, or discomfort caused physical activity levels. Only 13 of 195 patients were physically active, so the adjusted analysis rests on a small active group. Interviews included only patients, not family members or other stakeholders, although family and peer influence was reported by patients. The study excluded patients with acute infection, malignant tumour, acute cerebrovascular disease, terminal illness, or severe mental disorders, so it may not apply to those groups.
Declared interests
The authors declared no conflicts of interest. The study was funded by Shanghai public health, Fudan University and Zhongshan Hospital, Shanghai Municipal Health Commission, National Key R&D Program of China, and cardiovascular nursing program grants.
The easy way to misread this
Do not read the link between post-discharge professional support and physical activity as proof that advice causes more exercise. This was a survey and interview study, not a tested rehabilitation programme.