NDLI: Feasibility and Effects of Cardiac Rehabilitation for Individuals after Transient Ischemic Attack.

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Feasibility and Effects of Cardiac Rehabilitation for Individuals after Transient Ischemic Attack.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Marzolini, Susan Danells, Cynthia Oh, Paul I. Jagroop, David Brooks, Dina
Description	Author Affiliation: Marzolini S ( Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada. Electronic address: Susan.marzolini@uhn.ca.); Danells C ( Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada); Oh PI ( Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada); Jagroop D ( Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada); Brooks D ( Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada)
Abstract	BACKGROUND AND OBJECTIVE: Cardiac rehabilitation programs (CRPs) are common for cardiac patients; however, most individuals post transient ischemic attack (TIA) receive no rehabilitation despite similar pathologies. The objective of this study is to determine effects of cardiac rehabilitation (CR) on cardiovascular fitness (peak oxygen uptake [VO2peak]) and 6-minute walk distance (6MWD) post TIA. Secondary outcomes included other clinical and process indicators. METHODS: Eighty-five people post TIA (mean age 67.5 ± 10.7, 47% female) were referred to CR (2006-2014). The retro-TIA cohort included 65 consecutively enrolled individuals who were evaluated retrospectively. To collect additional measures, the pro-TIA cohort included 20 participants who were followed prospectively with a 3-month nonintervention period followed by 6-months of CR with 6MWD, cognition, depression score, and anthropometrics measured at each time point. Baseline, 6-month cardiopulmonary exercise test results, depression score, and anthropometrics were examined separately for both cohorts. RESULTS: Among all participants, 62% completed CR with 72.8 ± 17.7% attendance to prescheduled classes. CR resulted in improvements in VO2peak for both cohorts (both, P < .02). In the retro-TIA cohort, there were improvements in resting heart rate and body mass index, with reductions in the proportion of people with obesity and abdominal obesity (all, P < .04). In the pro-TIA cohort, compared to the stable baseline period there was a significant improvement with the CR intervention in the depression score (Δ1.1 ± 4.3 and Δ-3.3 ± 3.9, respectively; P = .04) but not in 6MWD (Δ4.8 ± 42 m and Δ61.0 ± 73.5 m, respectively; P = .06). For all participants, regression analysis revealed a higher depression score (ß = 1.10, P = .02), male sex (ß = 4.932, P = .02), and less social support (ß = 4.085, P = .04) as predictors of dropout. CONCLUSIONS: A CRP is feasible and effective for improving cardiovascular health. Strategies to promote adherence in men, in those with depressive symptoms, and in those with less social support require investigation.
File Format	HTM / HTML
ISSN	10523057
Issue Number	10
Journal	Journal of Stroke and Cerebrovascular Diseases
Volume Number	25
e-ISSN	15328511
Language	English
Publisher	Elsevier
Publisher Date	2016-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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