Adapted Cardiac Rehabilitation After Stroke

Overview

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.

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