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June 9, 2010BMC Neurology93 citationsOpen Access

Feasibility and effects of adapted cardiac rehabilitation after stroke: a prospective trial

ATAda TangSMSusan MarzoliniPOPaul Oh

Key Result

A 6-month adapted cardiac rehabilitation program was highly feasible and significantly improved aerobic capacity (VO2peak) from 14.8 to 16.2 ml·kg-1·min-1 (P=0.046) in stroke survivors.

Structured PICO

Does a 6-month adapted cardiac rehabilitation program improve feasibility and aerobic capacity in individuals with mild to moderate stroke disability?

P
Population
43 adults with mild to moderate stroke disability (mean age 64.5 years, 30% female) participated in a 6-month adapted cardiac rehabilitation program following a 3-month baseline period.
I
Intervention
6-month adapted cardiac rehabilitation (CR) intervention
C
Comparator
3-month stable baseline period (repeated measures design)
O
Outcome
Feasibility (number of participants completing the study, occurrence of adverse events, and frequency, duration, and intensity of exercise performed)surrogate

Adapted cardiac rehabilitation is feasible, safe, and effective at improving aerobic capacity in survivors of mild to moderate stroke.

Main Result

Absolute Event Rate: 16.2% vs 14.8%

p-value: p=0.046

Limitations

  • Lack of an independent control group (single cohort design)
  • Potential underestimation of exercise volume due to assuming zero minutes for unsubmitted diaries
  • Unexpectedly high variance in 6-minute walk test scores, leaving the study underpowered for this outcome and risk factors
  • Lack of follow-up data to determine if observed benefits were retained after the program ended

Abstract

BACKGROUND: Despite the cardiovascular etiology of stroke, exercise and risk factor modification programs akin to cardiac rehabilitation (CR) are not available. This study aimed to establish the feasibility of adapting a CR model for individuals with mild to moderate stroke disability. A secondary objective was to determine the program's effects on aerobic and walking capacity, and stroke risk factors. METHODS: A repeated measures design was used with a 3-month baseline period and 6-month adapted CR intervention (n = 43, mean +/- SD age 65 +/- 12 years, 30 +/- 28 months post stroke). Feasibility was determined by the number of participants who completed the study, occurrence of adverse events and frequency, duration and intensity of exercise performed. To determine effectiveness of the program, outcomes measured included aerobic capacity (VO2peak, ventilatory threshold), 6-Minute Walk Test (6MWT) distance, and risk factors. Descriptive statistics characterized the classes attended and number and intensity of exercise sessions. Paired t-tests, one-factor repeated measures analyses of variance contrasts and chi-square analyses were used to compare changes over time. RESULTS: Two participants withdrew during the baseline period. Of the remaining 41 participants who commenced the program, 38 (93%) completed all aspects. No serious adverse effects occurred. Post-intervention, VO2peak improved relative to the stable baseline period (P = 0.046) and the increase in ventilatory threshold approached significance (P = 0.062). CONCLUSIONS: CR is feasible after stroke and may be adapted to accommodate for those with a range of post-stroke disability. It is effective in increasing aerobic capacity. CR may be an untapped opportunity for stroke survivors to access programs of exercise and risk factor modification to lower future event risk. TRIAL REGISTRATION: ClinicalTrials.gov registration number: NCT01067495.

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Cite This Study

Tang et al. (2010) studied Stroke (n=43). Adapted cardiac rehabilitation vs. Baseline period (intra-subject control) was evaluated on Aerobic capacity (VO2peak, ml·kg-1·min-1) (p=0.046). A 6-month adapted cardiac rehabilitation program was highly feasible and significantly improved aerobic capacity (VO2peak) from 14.8 to 16.2 ml·kg-1·min-1 (P=0.046) in stroke survivors.

synapsesocial.com/papers/6a20a74001bc09701ff37405https://doi.org/10.1186/1471-2377-10-40
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