PMID- 27425176
OWN - NLM
STAT- MEDLINE
DCOM- 20170410
LR  - 20170410
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 25
IP  - 10
DP  - 2016 Oct
TI  - Feasibility and Effects of Cardiac Rehabilitation for Individuals after Transient 
      Ischemic Attack.
PG  - 2453-63
LID - S1052-3057(16)30137-9 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2016.06.018 [doi]
AB  - 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 (Delta1.1 +/- 4.3 and Delta-3.3 +/- 3.9, respectively; P = .04) but not 
      in 6MWD (Delta4.8 +/- 42 m and Delta61.0 +/- 73.5 m, respectively; P = .06). For all 
      participants, regression analysis revealed a higher depression score (beta = 1.10, 
      P = .02), male sex (beta = 4.932, P = .02), and less social support (beta = 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.
CI  - Copyright (c) 2016 National Stroke Association. Published by Elsevier Inc. All 
      rights reserved.
FAU - Marzolini, Susan
AU  - Marzolini S
AD  - Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and 
      Rehabilitation Program, Toronto, Canada. Electronic address: 
      Susan.marzolini@uhn.ca.
FAU - Danells, Cynthia
AU  - Danells C
AD  - Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and 
      Rehabilitation Program, Toronto, Canada; Department of Physical Therapy, 
      University of Toronto, Toronto, Canada.
FAU - Oh, Paul I
AU  - Oh PI
AD  - Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and 
      Rehabilitation Program, Toronto, Canada; Canadian Partnership for Stroke 
      Recovery, Toronto, Canada.
FAU - Jagroop, David
AU  - Jagroop D
AD  - Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and 
      Rehabilitation Program, Toronto, Canada; Faculty of Health Sciences, University 
      of Ontario Institute of Technology, Oshawa, Canada.
FAU - Brooks, Dina
AU  - Brooks D
AD  - Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and 
      Rehabilitation Program, Toronto, Canada; Department of Physical Therapy, 
      University of Toronto, Toronto, Canada; Canadian Partnership for Stroke Recovery, 
      Toronto, Canada.
LA  - eng
PT  - Journal Article
DEP - 20160711
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Rehabilitation/*methods
MH  - Depression/psychology
MH  - Exercise Test
MH  - *Exercise Therapy
MH  - *Exercise Tolerance
MH  - Feasibility Studies
MH  - Female
MH  - Health Knowledge, Attitudes, Practice
MH  - Humans
MH  - Ischemic Attack, Transient/diagnosis/physiopathology/psychology/*rehabilitation
MH  - Male
MH  - Middle Aged
MH  - Ontario
MH  - Oxygen Consumption
MH  - Patient Compliance
MH  - Patient Dropouts
MH  - *Physical Fitness
MH  - Prospective Studies
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Social Support
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Walking
OTO - NOTNLM
OT  - Exercise
OT  - TIA
OT  - cardiovascular fitness
OT  - comprehensive cardiac rehabilitation
EDAT- 2016/07/19 06:00
MHDA- 2017/04/11 06:00
CRDT- 2016/07/19 06:00
PHST- 2016/03/24 00:00 [received]
PHST- 2016/06/08 00:00 [revised]
PHST- 2016/06/13 00:00 [accepted]
PHST- 2016/07/19 06:00 [entrez]
PHST- 2016/07/19 06:00 [pubmed]
PHST- 2017/04/11 06:00 [medline]
AID - S1052-3057(16)30137-9 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2016.06.018 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2016 Oct;25(10):2453-63. doi: 
      10.1016/j.jstrokecerebrovasdis.2016.06.018. Epub 2016 Jul 11.