Disclosures: Sara J. Cuccurullo, MD: Demos Medical (Royalties) NorthEast Cerebrovascular Consortium (NECC) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received) NuStep (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)  

Objective: Using a feasibility analysis and matched subgroup-analysis, this study investigated the implementation/safety/outcomes of a Stroke Recovery Program (SRP) integrating modified cardiac rehabilitation (CR) for stroke survivors.

Design: This prospective cohort study of 783 stroke survivors were discharged from an inpatient rehabilitation facility (IRF) to an outpatient setting; 136 SRP-participants completed a feasibility study and received the SRP including modified CR, 473 chose standard of care rehabilitation (non-participants) and a group (n=174) were excluded. The feasibility study assessed safety/mortality/pre-post cardiovascular-performance/pre-post function/patient/staff-perspective. In addition, a non-randomized subgroup-analysis compared SRP-participants (n=76) to matched pairs of non-participants (n=66, with 10 non-participants used more than once) for mortality/pre-post function.

Setting: Post-acute care transition from IRF to an outpatient setting.

Participants: Patients who agreed to participate in the full SRP (which required physician visits, outpatient therapy and modified CR at the institution) were enrolled in the SRP-participant group (n=136). Patients who opted out of the SRP and chose standard of care rehabilitation (physical therapy, occupational therapy and speech therapy when necessary) not located at the institution, were placed in the non-participant group (n=473).

Interventions: All patients diagnosed with stroke were offered participation in the SRP.

Main Outcome Measures: The SRP integrating modified CR assessed safety/mortality/progression of cardiovascular aerobic conditioning/functional status using the Activity Measure of Post-Acute Care (AM-PAC) instrument and testimonials were collected.

Results: The feasibility study showed the SRP to have 1) excellent safety, 2) markedly low 1-year post-stroke mortality from hospital admission (1.47%) compared to national rate of 31%, 3) improved cardiovascular-performance over 36 sessions (103% increase in Metabolic Equivalent of Tasks times minutes), 4) improved function in Activity Measure of Post-Acute Care (AM-PAC)TM domains (P<.001), 5) positive reviews from SRP-participants/staff. Subgroup-analysis showed the SRP to 1) positively impact mortality; non-participants had a 9.09 times higher hazard of mortality (P=.039), and 2) improve function in AM-PAC domains (P<.001).

Conclusions: Stroke survivors receiving a SRP integrating modified CR may benefit from reductions in all-cause mortality, and improvements in cardiovascular-performance and function. These results have been accepted for publication.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/impact-of-a-stroke-recovery-program-integrating-modified-cardiac-rehabilitation-on-all-cause-mortality-cardiovascular-performance-and-functional-performance/