Poster The Joint Annual Meeting of the Stroke Society of Australasia (SSA) and Smartstrokes 2023

Is early initiated stroke-integrated Cardiac Rehabilitation safe and feasible? (#236)

Natasha Machado 1 2 , Gavin Williams 1 2 , John Olver 1 2 3 , Liam Johnson 1 2 4
  1. Epworth HealthCare, Camberwell, Victoria, Australia
  2. Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
  3. Department of Medicine, Monash University, Melbourne, Victoria, Australia
  4. Faculty of Exercise Science, Australian Catholic University, Melbourne, Victoria, Australia

Background

Clinical practice guidelines recommend people with stroke should undergo cardiorespiratory fitness training and lifestyle modification education to support long-term management of risk factors. Cardiac rehabilitation (CR) is a well-established model of secondary prevention available to people with stroke, but access and uptake is limited.

Aim

To investigate the safety and feasibility of CR adapted for people with stroke in the early subacute phase.

Methods

People with acute first or recurrent ischaemic stroke or transient ischaemic attack admitted to Epworth HealthCare were screened for eligibility and invited to participate. Participants were integrated into a CR program, including cardiorespiratory fitness training 3-days/week during Phase 1 (inpatient rehabilitation), and 2-days/week centre-based cardiorespiratory fitness training + education and 1-day/week home-based cardiorespiratory fitness training for 6-weeks during Phase 2 (outpatient rehabilitation) in addition to usual care neurorehabilitation. Safety was determined by the number of adverse and serious adverse events. Feasibility was determined by participant recruitment, retention, and attendance rates, adherence to exercise recommendations, and participant satisfaction.

Results

There were no study-related adverse or serious adverse events. Of 117, 62 (53%) people with stroke were recruited, with only 10 (16.1%) withdrawals. Participants attended 189/201 (94%) scheduled cardiorespiratory fitness training sessions in Phase 1 and 341/381 (89.5%) scheduled sessions in Phase 2. Only 220/381 scheduled education sessions were attended. The minimum recommended cardiorespiratory fitness training intensity (40% heart rate reserve) and duration (20 minutes) was achieved by 57% and 55% of participants respectively during Phase 1, and 60% and 92% respectively during Phase 2. All respondents either strongly agreed (69%) or agreed (31%) they would recommend the stroke-integrated CR program to other people with stroke.

Conclusion

A stroke-integrated CR program, including cardiorespiratory fitness training, was safe and had good attendance and adherence rates. Recruitment and uptake of the education component was moderate.