Key result
A stroke recovery program integrating modified cardiac rehabilitation was associated with lower mortality, as nonparticipants had a 9.09 times higher hazard of death.
Why the study?
This study investigated the implementation, safety, and outcomes of a stroke recovery program integrating modified cardiac rehabilitation for stroke survivors using feasibility and matched subgroup analyses.
Does a stroke recovery program integrating modified cardiac rehabilitation reduce mortality and improve functional performance in stroke survivors?
Cohort (n=783)
Does a stroke recovery program integrating modified cardiac rehabilitation reduce mortality and improve functional performance in stroke survivors?
Integrating modified cardiac rehabilitation into a stroke recovery program significantly reduces 1-year mortality and improves functional and cardiovascular performance.
Answers are grounded in this paper and cite their sources.
Should not yet change practice in stroke survivors; hypothesis-generating for integrating modified cardiac rehabilitation into recovery programs.
OBJECTIVE: Using a feasibility analysis and matched subgroup analysis, this study investigated the implementation/safety/outcomes of a stroke recovery program (SRP) integrating modified cardiac rehabilitation for stroke survivors. DESIGN: This prospective cohort study of 783 stroke survivors were discharged from an inpatient rehabilitation facility to an outpatient setting; 136 SRP-participants completed a feasibility study and received the SRP including modified cardiac rehabilitation, 473 chose standard of care rehabilitation (nonparticipants), and a group (n = 174) were excluded. The feasibility study assessed the following: safety/mortality/pre-post cardiovascular performance/pre-post function/patient/staff perspective. In addition to the feasibility study, a nonrandomized subgroup analysis compared SRP-participants (n = 76) to matched pairs of nonparticipants (n = 66, with 10 nonparticipants used more than once) for mortality/pre-post function. RESULTS: The feasibility study showed the SRP to have the following (a) excellent safety, (b) markedly low 1-yr poststroke mortality from hospital admission (1.47%) compared with national rate of 31%, (c) improved cardiovascular performance over 36 sessions (103% increase in metabolic equivalent of tasks times minutes), (d) improved function in Activity Measure of Post-Acute Care domains (P < 0.001), (e) positive reviews from SRP-participants/staff. Subgroup analysis showed the SRP to (a) positively impact mortality, nonparticipants had a 9.09 times higher hazard of mortality (P = 0.039), and (b) improve function in Activity Measure of Post-Acute Care domains (P < 0.001). CONCLUSIONS: Stroke survivors receiving a SRP integrating modified cardiac rehabilitation may potentially benefit from reductions in all-cause mortality and improvements in cardiovascular performance and function.
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Cuccurullo et al. (2019) conducted a cohort in Stroke (n=783). Stroke recovery program integrating modified cardiac rehabilitation vs. Standard of care rehabilitation was evaluated on Mortality (HR 9.09, p=0.039). A stroke recovery program integrating modified cardiac rehabilitation was associated with lower mortality, as nonparticipants had a 9.09 times higher hazard of death.
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