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Clinical Rehabilitation, Vol. 22, No. 2, 125-133 (2008)
DOI: 10.1177/0269215507081580
© 2008 SAGE Publications

A pilot randomized controlled trial to evaluate the benefit of the cardiac rehabilitation paradigm for the non-acute ischaemic stroke population

Olive Lennon

Stroke Rehabilitation Unit, Baggot Street Community Hospital, olive.lennon{at}hse.ie

Aisling Carey

Stroke Rehabilitation Unit, Baggot Street Community Hospital

Niamh Gaffney

Stroke Rehabilitation Unit, Baggot Street Community Hospital

Julia Stephenson

Stroke Rehabilitation Unit, Baggot Street Community Hospital

Catherine Blake

School of Physiotherapy and Performance Science, University College Dublin, Ireland

Objective: To evaluate risk factor reduction and health-related quality of life following a 10-week cardiac rehabilitation programme in non-acute ischaemic stroke subjects. Design: Single-blinded randomized control trial.

Setting: Outpatient rehabilitation.

Subjects: Forty-eight community-dwelling ischaemic stroke patients (38 independently mobile, 9 requiring assistance, 1 non-ambulatory) were randomly assigned to intervention or control groups by concealed allocation.

Intervention: The trial consisted of a 10-week schedule with measures taken at weeks 1 and 10. Both groups continued usual care (excluding aerobic exercise); intervention subjects attended 16 cycle ergometry sessions of aerobic-training intensity and two stress-management classes.

Main outcome measures: Cardiac risk score (CRS); VO2 (mL O2/kg per minute) and Borg Rate of Perceived Exertion (RPE) assessed during a standardized ergometry test; Hospital Anxiety and Depression Scale (HADS); Frenchay Activity Index; Fasting Lipid Profiles and Resting Blood Pressure.

Results: Group comparison with independent t-tests showed significantly greater improvement at follow-up by intervention subjects than controls in VO2 (intervention 10.6 ±1.6 to 12.0 ± 2.2, control 11.1 ±1.8 to 11.1 ±1.9 t=4.734, P<0.001) and CRS (intervention 13.4 ±10.1 to 12.4 ±10.5, control 9.4 ±6.7 to 15.0 ±6.1 t=-2.537, P<0.05). RPE rating decreased in intervention subjects (13.4 ±12.2 to 12.4 ±2.0) and increased in controls (13.8 ±1.8 to 14.4 ±1.6); Mann—Whitney U (U = 173.5, P<0.05). Within-group comparison showed significant decrease in the HADS depression subscale in the intervention group alone (5.1 ±3.4 to 3.0 ±2.8) (Wilcoxon signed ranks test Z=-3.278, P<0.001).

Conclusion: Preliminary findings suggest non-acute ischaemic stroke patients can improve their cardiovascular fitness and reduce their CRS with a cardiac rehabilitation programme. The intervention was associated with improvement in self-reported depression.


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