Relationship Between Exercise Training Adherence and Improvement in Functional Capacity Among Transient Ischemic Attack and Mild Non-disabling Stroke Survivors in Cardiac Rehabilitation
Abstract
Introduction: Transient ischemic attack (TIA) is characterized by temporary neurological dysfunction and carries a short-term risk of stroke, hospitalization, and death. Cardiac rehabilitation and secondary prevention (CRSP) involving behavior change and exercise reduces morbidity and mortality among heart patients but is typically not offered after TIA, despite similarities in risk factors between coronary artery disease and stroke. Current stroke secondary prevention strategies are suboptimal.
Objectives: To quantify the relationship between exercise adherence and functional capacity at CRSP exit among exercise-trained TIA and mild non-disabling stroke (MNDS) patients and to determine if CRSP improves physical and psychological outcomes.
Methods: From 2004 to 2014, 115 exercise-trained TIA/MNDS across three studies were used for this study. Linear regression was used to analyze the primary objective and paired t-tests were used to compare intake and exit measures of the secondary objectives.
Results: There was a positive relationship between exercise attendance and improvement in functional capacity and the participants had clinically significant improvements in key cardiovascular risk factors and psychometrics.
Conclusion: This study illustrated a “dose-response like” relationship between exercise attendance and functional capacity that reached a clinically significant improvement of 0.5 METS (Canadian Cardiovascular Society quality indicator). Future work should investigate the long-term impact of CRSP for TIA/MNDS patients as well as cost-effectiveness analyses.