title: Feasibility and Effects of Cardiac Rehabilitation for Individuals after Transient Ischemic Attack.
abstract: 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 (Δ1.1 ± 4.3 and Δ-3.3 ± 3.9, respectively; P = .04) but not in 6MWD (Δ4.8 ± 42 m and Δ61.0 ± 73.5 m, respectively; P = .06). For all participants, regression analysis revealed a higher depression score (β = 1.10, P = .02), male sex (β = 4.932, P = .02), and less social support (β = 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.
authors.affiliation: Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada. Electronic address: Susan.marzolini@uhn.ca.
authors.forename: Susan
authors.initials: S
authors.lastname: Marzolini
authors.affiliation: Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada; Department of Physical Therapy, University of Toronto, Toronto, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Danells
authors.affiliation: Toronto Rehab Institute, University Health Network, Cardiovascular Prevention and Rehabilitation Program, Toronto, Canada; Canadian Partnership for Stroke Recovery, Toronto, Canada.
authors.forename: Paul I
authors.initials: PI
authors.lastname: Oh
authors.affiliation: 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.
authors.forename: David
authors.initials: D
authors.lastname: Jagroop
authors.affiliation: 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.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation / Q000379:methods*; D003863:Depression / Q000523:psychology; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009864:Ontario; D010101:Oxygen Consumption; D010349:Patient Compliance; D010352:Patient Dropouts; D010809:Physical Fitness; D011446:Prospective Studies; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D012944:Social Support; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking
keywords: Exercise; TIA; cardiovascular fitness; comprehensive cardiac rehabilitation