Cardiovascular rehabilitation did not improve 6-minute walk test distance vs usual care, but significantly improved AQoL-6D coping scores at 6 weeks (β 3.6; 95% CI 0.07-7.2).
RCT (n=140)
1:1
No
Does a once-weekly 6-week cardiovascular rehabilitation programme improve functional exercise capacity and quality of life in adults with recent TIA or mild stroke?
A 6-week cardiovascular rehabilitation program for patients with recent TIA or mild stroke did not improve exercise capacity compared to usual care, though it provided short-term improvements in quality-of-life coping scores.
Effect estimate: β 3.6 (95% CI 0.07-7.2)
Objectives Evaluate the effectiveness of integrated cardiovascular rehabilitation on functional exercise capacity, physical activity, anthropometrics, blood pressure, quality-of-life, anxiety, and depression, for people with transient ischaemic attack (TIA) or mild stroke, over 6 months compared with usual care. Design Randomised controlled trial. Setting University health centre. Participants Adults (≥18 years) with a TIA or mild stroke in the past 12-months. Intervention Overall, 140 TIA and mild stroke participants were randomised 1:1 to a once-weekly 6-week cardiovascular rehabilitation programme ( n = 70), or usual care ( n = 70). Main measures Outcomes assessed at baseline, 6 weeks, and 6 months included 6-min walk test distance (6MWTD), moderate-to-vigorous physical activity, body mass index, waist circumference, blood pressure, Assessment of Quality-Of-Life 6 dimensions (AQoL-6D) and Hospital Anxiety and Depression Scale. Results Participants’ median age was 73 years (interquartile range 63–80). Fully-adjusted analyses showed no between-group differences in 6MWTD, while AQoL-6D coping scores improved significantly, favouring cardiovascular rehabilitation at 6 weeks (β: 3.6, 95% CI: 0.07–7.2). There were significant within-group improvements in the intervention group only for AQoL-6D mental health at 6 weeks and coping at 6 months. No other outcomes differed between groups. Subgroup analyses showed small, non-significant 6MWTD gains among TIA intervention participants (Cohen's d = 0.40). Conclusions Cardiovascular rehabilitation was not more effective than usual care in improving exercise capacity, physical activity, anthropometrics, blood pressure, anxiety or depression. Though a short-term quality-of-life improvements suggest psychosocial benefits. Future studies should explore minimum effective programme dosage using sensitive exercise capacity measures, evaluating TIA and mild stroke populations separately. Clinical Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12621001586808, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001586808
Walton et al. (Tue,) conducted a rct in transient ischaemic attack (TIA) or mild stroke (n=140). cardiovascular rehabilitation vs. usual care was evaluated on 6-min walk test distance (6MWTD), physical activity, anthropometrics, blood pressure, AQoL-6D, and Hospital Anxiety and Depression Scale (β 3.6, 95% CI 0.07-7.2). Cardiovascular rehabilitation did not improve 6-minute walk test distance vs usual care, but significantly improved AQoL-6D coping scores at 6 weeks (β 3.6; 95% CI 0.07-7.2).