Rehabilitation Programme for stroke survivors may improve heart health and reduce mortality

Stroke survivors who participated in a comprehensive stroke recovery program incorporating modified cardiac rehabilitation had decreased all-cause mortality, improved overall function, and improved cardiovascular performance, according to the latest study published in the Journal of Stroke and Cerebrovascular Diseases.

Despite advances in acute stroke treatment, stroke continues to be a leading cause of serious long-term disability. Stroke ranks fifth among all causes of death when considered

separately from other cardiovascular diseases. Studies show that 35% to 40% of individuals have limitations in basic activities of daily living six months after a stroke.

Cardiac rehabilitation (CR) has been shown to improve cardiac outcomes and provide a better quality of life after myocardial infarction, percutaneous coronary angioplasty, coronary artery bypass graft, and heart failure. For those patients who are eligible, a comprehensive CR program is funded by the Center of Medicare & Medicaid Services (CMS) and other insurance providers.

CR has been shown to reduce 5-year all-cause mortality by 45% after percutaneous coronary intervention.

The study conducted by U.S.-based researchers tried to investigate the effect of a stroke recovery program (SRP) integrating modified cardiac rehabilitation on mortality and functional outcomes for stroke survivors.

This study used a retrospective analysis of data from a prospectively collected stroke rehabilitation database which followed 449 acute stroke survivors discharged from an inpatient rehabilitation facility between 2015 and 2020.

For 1-year post-stroke, 246 SRP participants and 203 nonparticipants were compared.

The association of the SRP including modified cardiac rehabilitation with all-cause mortality and functional performance was assessed using the following statistical techniques:

log-rank test, Cox proportional hazard model, and linear mixed effect models.

Cardiovascular performance over 36 sessions of modified cardiac rehabilitation was assessed using a linear effect model with the Tukey procedure.

The primary outcome measure was 1- year all-cause mortality rate.

Secondary outcomes were functional performance measured in Activity Measure of Post-Acute Care scores and cardiovascular performance measured in metabolic equivalent of tasks times minutes.

The SRP participants exhibited changes in the following parameters:

(1) They showed a significantly reduced 1-year post-stroke mortality rate from hospital admission corresponding to a four-fold reduction in mortality.

(2) Statistically and clinically significant improvement of function in all Activity Measure of Post-Acute Care domains compared to the matched cohort and,

(3) An improvement in cardiovascular performance over 36 sessions with an increase of 78% metabolic equivalent of tasks times minutes compared to baseline.

"Stroke survivors who participated in a comprehensive stroke recovery program incorporating modified cardiac rehabilitation had decreased all-cause mortality, improved overall function, and improved cardiovascular performance," the authors conclusively stated.