Attitudes of cardiac rehabilitation and stroke teams towards integration of stroke survivors into adapted cardiac rehabilitation: A focus group study.
Nicola Clague-Baker, Thompson Robinson, Annegret Hagenberg and 2 others
PMID 38751105WHAT IT FOUND
Cardiac rehab staff reported positive experiences integrating stroke survivors but lacked confidence managing stroke-specific issues like tone and fatigue.
Stroke teams doubted cardiac staff's ability to provide safe support. Both groups agreed a specialist stroke physiotherapist must be present in classes.
Key findings
01Both cardiac rehabilitation and stroke teams identified that having a specialist stroke physiotherapist present in the adapted cardiac rehabilitation class was the main adaptation required for safe and effective integration.
02Stroke therapists initially expressed concern that exercise could worsen high tone and cause asymmetry, but these concerns lessened after observing that tone did not increase during the six-week programme.
03Cardiac rehabilitation staff reported a lack of knowledge and confidence in managing stroke survivors, specifically regarding splints, quality of movement, and identifying signs like fatigue or shoulder pain, which stroke teams were more aware of.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Not all members of the stroke and cardiac rehabilitation teams were represented in the focus groups. The facilitators and data analysts were healthcare professionals involved in the adapted cardiac rehabilitation programme, which may have introduced bias. The study explored staff attitudes and did not measure patient outcomes directly.
Declared interests
The authors declared that Professor Robinson and Professor Singh are NIHR Senior Investigators. The study was funded by The Stroke Association.
The easy way to misread this
Do not interpret the cardiac staff's positive attitude towards the programme as evidence that standard cardiac rehabilitation is safe for all stroke survivors without adaptation. The study explicitly states that confidence and knowledge gaps existed, and that a specialist stroke physiotherapist was considered essential for safe delivery.