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A Comparison of Cardiac Rehabilitation for Non-disabling Stroke and Cardiac Conditions: Outcomes and Healthcare Professionals’ Perceptions

Year: 2020

Type: article

Abstract: Purpose: Emerging evidence supports cardiac rehabilitation for transient ischaemic attack (TIA)/nondisabling stroke secondary prevention.This study compares stroke and cardiac participant outcomes following cardiac rehabilitation and examines healthcare professionals' perspectives of cardiac rehabilitation for TIA/non-disabling stroke.Methods: (1) Retrospective chart review of stroke patients (n=100) referred to cardiac rehabilitation and a matched cardiac group.(2) Semi-structured focus group with healthcare professionals.Independent-t, Mann-Whitney-U, and chi-squared tests explored between-group differences.Qualitative data were analysed thematically.Results: Compared to cardiac counterparts, programme enrolment among stroke patients was lower (57% versus 97%) and dropout rates were higher (39% versus 15%), p<0.001.Healthcare professionals largely attributed this to perceived cognitive impairment.No significant changes were observed between groups in cardiovascular fitness (modified Bruce protocol metabolic equivalent of task [MET] and duration), blood pressure, Hospital Anxiety and Depression Scale, or fasting cholesterol levels, except low-density lipoproteins which reduced more in stroke participants (p<0.005).Both groups made significant improvements post-cardiac rehabilitation in MET (stroke: 2.0±1.9;p<0.001), (cardiac: 2.2±1.6;p<0.001); stress test duration (stroke: 2 min±2.2;p<0.001), (cardiac: 2.1 min±2.3;p<0.001); systolic blood pressure (stroke: -16.1 mmHg±20.2;p<0.001), (cardiac: -11.1±18.0;p<0.001); low-density lipoprotein (stroke: -1.2 mmol/L±1.0;p<0.001), (cardiac: -0.7±0.9;p<0.001); and triglycerides (stroke: -0.6 mmol/L±0.9;p<0.001), (cardiac: -0.3±0.9;p=0.002).Significant within-group reductions in total cholesterol were observed in stroke only (-1.3 mmol/L±1.2;p<0.001).Reductions in anxiety scores in the Hospital Anxiety and Depression Scale (-0.9; p=0.01) in cardiac participants were not replicated in stroke.Qualitative data identified similar exercise ability in both groups but noted individuals with stroke engaged less in education sessions.

Source: EMJ Interventional Cardiology

DOI: 10.33590/emjintcardiol/20-00015