Medically complex stroke survivors who completed a comprehensive yet modified cardiac rehabilitation program had 76% lower odds of dying within a year than their peers who had usual care, investigators say.
Rehab recipients were enrolled in the ongoing Stroke-HEART trial at a rehabilitation institute in Edison, NJ. They received 36 sessions of medically supervised interval cardiovascular training and physician follow-up. They also received psychological, nutritional and educational support along with management for risk factors such as smoking, diet and exercise.
In a matched subgroup of nearly 500 stroke survivors, the 246 who completed the program had a fourfold reduction in all-cause mortality at one year when compared with non-participants. They also saw a 78% increase in their cardiac capacity, a special benefit considering that many stroke patients also have cardiovascular disease, the researchers noted.
The study also showed that stroke patients can exercise safely with modifications such as the use of recumbent bicycles, the researchers said. This was true even in cases of hemiplegia, where one half of the body was paralyzed by the prior stroke, they added.
The investigators plan to use their findings to encourage the Centers for Medicare & Medicaid Services to cover comprehensive stroke rehabilitation.
“Stroke survivors deserve the same benefits that patients with cardiac disease receive,” said study co-lead Talya Fleming, M.D. “We should enable stroke survivors to function in the community at the highest level possible.”
Full findings were published in the Journal of Stroke & Cerebrovascular Diseases.