Cardiac Rehab Improves Stroke Recovery, Reduces Mortality

Stroke patients enjoyed better recoveries and had a reduced risk of mortality if part of their treatment plan included cardiac rehabilitation, a recent study found.

Researchers examined 449 acute stroke survivors in the study, published May 1 in the Journal of Stroke and Cerebrovascular Diseases.

The authors reviewed patients from 2015 through 2020 and examined their health one year after suffering a stroke.

Patients who engaged in a stroke recovery program performed markedly better than those who did not have similar rehabilitation.

Sara J. Cuccurullo

“Stroke survivors who participated in a comprehensive stroke recovery program incorporating modified cardiac rehabilitation had decreased all-cause mortality, improved overall function, and improved cardiovascular performance,” wrote lead author Sara J. Cuccurullo, M.D., of the JFK Johnson Rehabilitation Instiute at Hackensack Meridian Health in Edison, New Jersey, and her co-authors.

About 7 million Americans have suffered a stroke, and 35% to 40% of those experience some kind of reduction in basic activities within six months of their stroke, researchers noted.

One in 6 deaths from cardiovascular diseases has occurred due to stroke, according to the U.S. Centers for Disease Control and Prevention. Every 40 seconds, an American suffers a stroke.

The researchers examined 246 individuals who had participated in a stroke rehabilitation program and 203 people who did not take part in a rehab program.

One year post-stroke, there were 4 deaths (1.6%) in the group that participated in a stroke rehab program. There were 14 deaths (6.9%) among the smaller group that didn’t take part in the rehabilitation program.

To put it in perspective, the authors noted that participants in stroke rehabilitation therapy had an estimated 76.5% reduction in mortality.

Patients were also generally healthier with stroke rehabilitation programs, and were less likely to require readmission to the hospital.

Cuccurullo and her colleagues noted that the study’s findings suggest broad value in not only helping patients recover but cutting costs for the Centers for Medicare and Medicaid Services. Stroke-related costs in the U.S. reached $53 billion between 2017 and 2018, the CDC reports.

Considering the improved health outcomes for participants in stroke rehabilitation programs and the possible savings in healthcare costs, the researchers wrote, “it would be beneficial to stroke survivors, for this program to be supported nationwide at the federal level, much the way that CR (cardiac rehabilitation) is supported for patients with cardiac disease.”

“Our results provide supportive evidence for the potential expansion of cardiac rehabilitation compliant diagnostic criteria to include patients with stroke,” the authors wrote. “Future studies in this area will build on the evidence-based data to change healthcare policy to support stroke survivors in a similar way as patients with cardiac disease.”

Those who participated in rehabilitation visited with doctors, engaged in outpatient therapy and some modified cardiac rehabilitation, Cuccurullo and her co-authors said. The “nonparticipants” were referred to primary care doctors and participated in physical therapy, occupational therapy and speech therapy when needed.

The authors note one limitation of the study is that it is an observational study. Theey also noted that data came from a single facility, the JFK Johnson Rehabilitation Institute, an acute inpatient rehabilitation facility.

However, the study included participants who reflected the national population in terms of gender, race, ethnicity and insurance status, the authors said. Researchers also noted the study followed patients for more than a year, and it addressed functional improvement and cardiac performance.

The stroke recovery program “embodies the potential to represent a comprehensive model for post-acute care for stroke survivors,” Cuccurullo and her colleagues wrot. In additio to Researchers Hackensack Meridian Health, the researchers involved in this study came from the Rutgers Robert Wood Johnson Medical School and Burke Rehabilitation Hospital.