Aerobic Training in Canadian Stroke Rehabilitation Programs

Area of Science:

• Cardiovascular Rehabilitation
• Neurological Rehabilitation
• Exercise Science

Background:

• Aerobic training (AT) is a recommended intervention for individuals post-stroke.
• The implementation and operationalization of AT in Canadian clinical stroke rehabilitation settings remain unquantified.
• This study addresses the gap in understanding AT adoption and its associated challenges in Canada.

Purpose of the Study:

• To survey the inclusion of structured aerobic training (AT) in Canadian stroke rehabilitation programs.
• To identify barriers to the implementation of AT in these programs.
• To assess adherence to best practices in pre-participation testing and patient monitoring.

Main Methods:

• A web-based questionnaire was distributed to 89 stroke rehabilitation program leads across Canada.
• Data were collected from 46 programs representing 7 provinces and territories.
• The survey focused on AT inclusion, patient exclusion criteria, implementation barriers, and adherence to guidelines.

Main Results:

• Seventy-eight percent of surveyed programs include AT, with many excluding patients with severe physical impairments or cardiac conditions.
• Insufficient therapy time and short rehabilitation stays were the primary barriers to AT implementation.
• Adherence to pre-participation exercise testing and monitoring guidelines for high-risk populations was inconsistent, with limited electrocardiography use.

Conclusions:

• While most Canadian stroke rehabilitation programs offer AT, significant challenges hinder its widespread adoption and optimal application.
• Exclusion of patients with comorbidities and inadequate monitoring practices highlight critical areas for improvement.
• Enhanced guidelines and targeted training are essential to overcome implementation barriers and ensure safe, effective AT for all stroke survivors.