BACKGROUND: To compare the effects of a 12-week prehabilitation (PREHAB) programversus usual care (UC) on functional capacity in adults listed for heart transplantation. Secondary aims included comparing peak oxygen uptake (VO2peak), frailty, physical activity, mental health, cognitive function, quality of life (QoL), and dietary habits. METHODS: A multicentre randomized controlled trial was conducted. Participants were randomized to PREHAB or UC. The 12-week PREHAB program included twice weekly high-intensity interval training sessions on an upright cycle ergometer, a stress management course, and a nutrition workshop. The primary outcome was functional capacity (6-minute walk test distance) from baseline to 12 weeks of follow-up. Secondary outcomes included changes in VO2peak, frailty, physical activity, severity of anxiety, depression, and stress, cognitive function, QoL, and dietary habits. RESULTS: Trial recruitment began in October 2018 and closed, due to the COVID-19 pandemic, in October 2020. Of 84 patients screened, 17 were recruited (age 44 +/- 9 years, 71% male), and 4 were randomized (PREHAB = 2; UC = 2). Both patients completed PREHAB, and 1 patient completed UC. Reasons for dropout throughout the trial included the following: receiving a transplant; medication and device contraindications; commitment and travel constraints; and lack of interest. PREHAB showed potential for improvements in the 6-minute walk test distance (Baseline (B): 343 +/- 120; follow-up (FU): 465 m), VO2peak (B: 14.9 +/- 0.1; FU: 15.8 +/- 0.4 mL/kg/min), and QoL measured using the Minnesota Living with Heart Failure Questionnaire (B: 41 +/- 33; FU: 26 +/- 1 points). CONCLUSIONS: Recruitment for and completion of PREHAB for patients listed for heart transplantation proved challenging. Given wait-time limitations, future research should examine alternative PREHAB programming, offered sooner following listing, that addresses reported barriers to participation. CLINICAL TRIAL REGISTRATION: NCT02957955.

Full text (sometimes free) may be available at these link(s):      help

• PubMed Central
• DOI
• PubMed
• publisher