Table 2.
Descriptive characteristics for CRPs that include people poststroke in regular CR classes
| Characteristic | CRPs that include stroke n = 74 n (%) |
|---|---|
| CRP stroke funding source n = 59 | |
| Hospital/clinical center funding | 31 (52.5) |
| +Health insurance (1) foundation (1) research (1) | |
| Government funding/health insurance | 21 (35.6) |
| +User fee (7) hospital (2) | |
| User fee as sole method of funding | 6 (10.2) |
| Fundraising/foundation only | 1 (1.7) |
| Eligibility criteria∗ (n = 67) | |
| Diagnosis of stroke alone is sufficient | 49 (73.1) |
| Only those with coronary artery disease | 17 (24.6) |
| Must be living in the community (not long-term care) | 32 (47.8) |
| Not currently participating in active SR | 15 (22.4) |
| Have own transportation to facility and able to get to treatment area from front door (e.g., 100 m, 10-min walk) | 5 (7.5) |
| Able to function in group setting | 5 (7.5) |
| Able to get on/off equipment independently | 5 (7.5) |
| Not a significant falls risk | 2 (3) |
| Other, independent toileting (1) no significant pain (1), complete a 6MWT (1), exercise for 0.5 to 1 h with breaks (1) | 4 (6) |
| Minimum days since stroke to be eligible (n = 68) | |
| Start any time after stroke | 26 (38.2) |
| Minimum 14 d | 1 (1.5) |
| Minimum 28-42 d | 12 (17.6) |
| Minimum 60-70 d | 2 (2.9) |
| When medically stable/referral from physician | 13 (19) |
| After completion of SR | 10 (14.7) |
| Other (ie, depends on the cardiac condition, discussed at team rounds, long wait-list) | 4 (5.9) |
| Upper limit of time since stroke, beyond which the patient is not eligible (n = 67) | |
| No upper limit | 57 (85.1) |
| 12 mo poststroke | 4 (6.0) |
| Other (unsure, based on physician referral, patient assessment [2], not specified [2]) | 6 (9.0) |
| Exercise program delivery model for people poststroke (n = 66) | |
| Integrated into CR class/sessions only | 55 (83.3) |
| Offers both stroke class/sessions separate from cardiac and integrated into CR | 10 (15.2) |
| Only offers stroke class separate from cardiac classes | 1 (1.5) |
| Model of supervision (n = 59) | |
| 1:1 beginning then group-based | 38 (64.4) |
| Entirely group-based | 20 (33.9) |
| 1:1 periodically with home-based exercise alone | 1 (1.7) |
| Program model (n = 42) | |
| Hybrid program: combination of home-based exercise independent of rehabilitation staff and regular supervised facility-based exercise | 29 (69) |
| Option of home-based with periodic 1:1 sessions | 8 (19.1) |
| Supervised on-site sessions only | 1 (2.4) |
| Telemedicine option | 3 (7.1) |
| Supervised on-site sessions only | 11 (26.2) |
| Home-based with periodic 1:1 session alone | 2 (4.8) |
| Combined with web-based | 1 (2.4) |
| Education specific to stroke, n = 61 | |
| Yes | 24 (39.3) |
| No | 36 (59) |
| Sometimes | 1 (1.6) |
| Proportion of people poststroke enrolled in CR program† (n = 61) | |
| < 1% | 10 (16.4) |
| 1%-2% | 7 (11.5) |
| 3%-4% | 17 (27.9) |
| 5%-10% | 10 (16.4) |
| > 10% | 6 (9.8) |
| I do not know | 11 (18.0) |
| No. of people poststroke accepted in last calendar year† (n = 62) | |
| 1-10 | 35 (56.5) |
| 11-20 | 9 (14.5) |
| 21-50 | 4 (6.4) |
| 50-100 | 4 (6.4) |
| > 100-200 | 4 (6.4) |
| I do not know | 6 (9.8) |
| Limit to No. of patients with stroke admitted (n = 61) | |
| No limit | 54 (88.5) |
| 200 patients | 2 (3.3) |
| 20 patients | 1 (1.6) |
| Other (availability space, personnel, 1/3 total volume, do not know) | 4 (6.6) |
| No. of years accepting patients with stroke into program† (n = 61) | |
| < 5 y | 10 (16.4) |
| 5-10 y | 11 (18.0) |
| > 10 y | 26 (42.6) |
| I do not know | 14 (23.0) |
| Wait-list of people poststroke† (n = 61) | |
| No wait-list | 31 (50.8) |
| 0-4 wk | 10 (16.4) |
| 5-8 wk | 14 (23.0) |
| > 8 wk | 4 (6.6) |
| I do not know | 2 (3.3) |
| No. of weekly classes available poststroke (n = 58) | |
| 1 class/wk | 10 (17.2) |
| 2-4 classes/wk | 35 (60.3) |
| 5-9 classes/wk | 8 (13.8) |
| 10-15 classes/wk | 2 (3.4) |
| > 15 classes/wk | 3 (5.2) |
| RT prescribed poststroke (n = 61) | |
| Yes | 50 (82) |
| No | 9 (14.8) |
| Other, classroom instruction but no supervised training (1) not specified (1) | 2 (3.3) |
| GXT and functional capacity tests (n = 59) | |
| GXT with ECG and BP for patients with and without mobility deficits | 13 (22.0) |
| GXT with ECG and BP only for patients with no mobility deficits | 16 (27.1) |
| GXT with ECG and BP only for patients with stroke in combination with cardiac conditions with or without mobility deficits | 5 (8.5) |
| No exercise stress tests conducted for CAD or stroke | 17 (28.8) |
| 6WMT for stroke with mobility deficits | 4 (6.8) |
| 6MWT alone or with DASI for any stroke | 3 (5.1) |
| ECG telemetry during 6MWT or during an exercise session for stroke with or without mobility deficits | 2 (3.3) |
| DASI alone | 1 (1.7) |
| Method of determining resistance intensity poststroke (n = 60) | |
| Not prescribed | 5 (8.3) |
| 1 repetition maximum (1RM) at least | 9 (15) |
| RPE | 33 (55) |
| Comfortable weight load alone | 11 (18.3) |
| Other (based on medical history and staff member determines resistance) | 2 (3.3) |
| Method of determining aerobic exercise intensity poststroke (n = 62) | |
| RPE (in combination with most methods below) | 56 (90.3) |
| Based on results of GXT data | 34 (54.8) |
| Based on functional test (i.e., 6MWT) | 27 (43.5) |
| 6MWT+GXT/6MWT+talk test | 12 (19.4)/1 (1.6) |
| Calculated age-adjusted target heart rate | 13 (21) |
| Estimated intensity based on clinical expertise | 27 (43.5) |
| Based on clinical expertise alone or with talk test or RPE | 7 (11.3) |
| Patient self-selected intensity | 18 (29) |
| Self-selected intensity alone | 1 (1.6) |
BP, blood pressure; CAD, coronary artery disease; CR, cardiac rehabilitation; CRP, cardiac rehabilitation program; DASI, Duke Activity Status Index (brief self-administered questionnaire to estimate functional capacity); ECG, electrocardiogram; GXT, graded exercise test; 1RM, 1 repetition maximum; RPE, rating of perceived exertion; RT, resistance training; 6MWT, 6-minute walk test; SR, stroke rehabilitation.
∗
Program managers were instructed to choose all that apply.
†
Number based on responses for CRPs that include people poststroke in regular cardiac rehabilitation sessions only.