Adapted Cardiac Rehabilitation After Stroke

February 10, 2010 updated by: Toronto Rehabilitation Institute

Feasibility and Effects of Cardiac Rehabilitation for Individuals After Stroke

Despite the similarities between heart disease and stroke in terms of disease process and elevated risk of recurrent events, exercise-based programs akin to cardiac rehabilitation are not available for people with stroke.

The purpose of this study is to examine 1) the feasibility of adapting cardiac rehabilitation for individuals with stroke, and 2) the effects of this program on aerobic capacity, walking, risk factors, community integration and quality of life.

The investigators anticipate that cardiac rehabilitation may be appropriately adapted to accommodate individuals with stroke who have a range of functional abilities, and that this program is effective in improving aerobic capacity, walking ability and stroke risk factors. The investigators also anticipate participants will demonstrate improved community integration and quality of life following this program.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

There are many parallels between heart disease in stroke, including their cardiovascular etiologies, presence of co-morbidities and similarities in risk factors. Cardiac rehabilitation is a well-established and successful model of care for individuals with heart disease that is focused on exercise and risk factor modification. Yet analogous secondary prevention programs for the stroke program are not readily available.

The main research question is: What is the feasibility and effect of cardiac rehabilitation in individuals following stroke?

The objectives are:

  1. To determine if stroke survivors are able and willing to participate in a cardiac rehabilitation program. Specifically, to determine the feasibility of the cardiac rehabilitation program in individuals following stroke as determined by compliance to attendance and training requirements.

  2. To determine if a cardiac rehabilitation program will have a meaningful benefit, among chronic stroke survivors, on:

    • walking capacity and ability: considering functional capacity [endurance / distance] and quality [neuromotor control],
    • community integration: considering quantity [activity monitors] and quality [index of reintegration to normal living] of activity
    • health-related quality of life: as determined by stroke specific index
    • risk factors for subsequent stroke: including exercise capacity, blood pressure, blood lipid profile

Study Type

Interventional

Enrollment (Actual)

43

Phase

  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M4G 1R7
        • Toronto Rehabilitation Institute Cardiac Rehabilitation and Secondary Prevention Program - Rumsey Centre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Chedoke-McMaster Stroke Assessment (CMSA) Scale Leg Score between 3 and 7
  • At least 3 months post-stroke
  • Ability to understand the process and instructions for exercise training and provide informed consent
  • Ability to complete 6-minute walk test

Exclusion Criteria:

  • Resting blood pressure greater than 160/100 despite medication
  • Other cardiovascular morbidity which would limit exercise tolerance (heart failure, abnormal blood pressure responses or ST-segment depression > 2 mm, symptomatic aortic stenosis, complex arrhythmias)
  • Unstable angina
  • Orthostatic blood pressure decrease of > 20 mm Hg with symptoms
  • Hypertrophic cardiomyopathy
  • Other musculoskeletal impairments which would limit the participant's ability to cycle or walk
  • Pain or other co-morbidities (e.g. unclipped aneurysms, uncontrolled seizures etc.) which would preclude participation
  • Cognitive and/or behavioural issues that would limit participation in exercise testing and training

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Exercise
Behavioral: Cardiac rehabilitation
Participants will participate in a 6-month cardiac rehabilitation exercise program. This program will include aerobic and resistance training, and education sessions on risk factor management.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Cardiorespiratory fitness (aerobic capacity) and walking capacity (6 minute walk test, spatiotemporal gait parameters)
Time Frame: Pre-baseline (-3 months), pre-program (0 months), post-program (6 months), follow up (12 months)
Pre-baseline (-3 months), pre-program (0 months), post-program (6 months), follow up (12 months)

Secondary Outcome Measures

Outcome Measure
Time Frame
Plasma lipid analysis, questionnaires pertaining to quality of life and community integration
Time Frame: Pre-baseline (-3 months), pre-program (0 months), post-program (6 months), follow up (12 months)
Pre-baseline (-3 months), pre-program (0 months), post-program (6 months), follow up (12 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Toronto Rehabilitation Institute

Collaborators

Heart and Stroke Foundation of Ontario

Investigators

  • Principal Investigator: Paul Oh, MD, Toronto Rehabilitation Institute
  • Principal Investigator: William E McIlroy, PhD, University of Waterloo

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2006

Primary Completion (Actual)

December 1, 2009

Study Completion (Actual)

December 1, 2009

Study Registration Dates

First Submitted

February 8, 2010

First Submitted That Met QC Criteria

February 10, 2010

First Posted (Estimate)

February 11, 2010

Study Record Updates

Last Update Posted (Estimate)

February 11, 2010

Last Update Submitted That Met QC Criteria

February 10, 2010

Last Verified

February 1, 2010

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HSFO-SRA5977

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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