Key result
Adapted cardiac rehabilitation proves feasible for sub-acute mild stroke, achieving ~80% class attendance.
Why the study?
To determine recruitment, acceptability, adherence, outcome measures, and adverse events for a definitive trial of adapted cardiac rehabilitation for people with mild-to-moderate sub-acute stroke.
Is a 6-week adapted cardiac rehabilitation program feasible and acceptable for patients with sub-acute mild-to-moderate stroke?
Is a 6-week adapted cardiac rehabilitation program feasible and acceptable for patients with sub-acute mild-to-moderate stroke?
A six-week adapted cardiac rehabilitation program is feasible and acceptable for patients in the sub-acute phase of mild stroke recovery.
Answers are grounded in this paper and cite their sources.
Supports feasibility in subacute mild stroke; hypothesis-generating and requires RCTs before practice change.
OBJECTIVE: To determine the recruitment strategy, acceptability, adherence, outcome measures, and adverse events for a definitive study that will explore adapted cardiac rehabilitation (CR) for people post-stroke with mild-to-moderate severity stroke in the sub-acute stage of recovery. DESIGN: Mixed methods feasibility study. SETTING: Acute hospital setting, neurology outpatients and community hospitals. PARTICIPANTS: 32 participants with stroke (mean age: 64.4 years) of median National Institutes of Health Stroke Scale (NIHSS) score 2 (range: 0 to 6) within six months of stroke. INTERVENTION: All participants attended six weeks, adapted CR within one to six months after a stroke. A combined class with people post cardiac event. MAIN OUTCOME MEASURES: Incremental shuttle walk test (ISWT), blood pressure, heart rate, weight, body mass index, quality of life, fatigue, anxiety and depression, tone, falls, stroke attitude and knowledge, physical activity (accelerometry) and functional ability. QUALITATIVE: Interviews with participants, non-participants and people post-cardiac event. Focus groups with Stroke and CR teams. RESULTS: 32 participants were recruited. The programme was acceptable to people with mild stroke (NIHSS<3) and people post cardiac events; 80% of classes attended, a mean of 9.6 classes, with six drop-outs. The ISWT was an acceptable outcome measure (for NIHSS<3) and most measures showed positive changes. There was one adverse event. CONCLUSION: A definitive study to determine the effect of six weeks of adapted CR on cardiorespiratory fitness (CRf) in people who have had a mild severity stroke (NIHSS<3) in the sub-acute phase of recovery, is feasible. Teams need specialist education and support. A more specialist service may be needed for people with a stroke severity defined by NIHSS>2. CLINICAL TRIAL REGISTRATION NUMBER: ISRCTN14861846.
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Clague-Baker et al. (2021) studied sub-acute, mild-to-moderate stroke (n=32). adapted cardiac rehabilitation (CR) was evaluated on recruitment strategy, acceptability, adherence, outcome measures, and adverse events. A six-week adapted cardiac rehabilitation program was feasible and acceptable for people with mild stroke (NIHSS<3) in the sub-acute phase, with 80% class attendance and one adverse event.
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