Background Evidence supports establishing a continuum of care from stroke rehabilitation (SR) to cardiac rehabilitation programs (CRPs). It is not known to what extent people poststroke are being integrated. This study aimed to determine the proportion of CRPs that accept referrals poststroke, barriers/facilitators, and eligibility criteria. Methods A web-based questionnaire was sent to CRPs across Canada. Results Of 160 questionnaires sent, 114 representatives (71%) of 130 CRPs responded. Of respondents, 65% (n = 74) reported accepting people with a diagnosis of stroke and doing so for a median of 11 years, 11 offering stroke-specific classes and an additional 6 planning inclusion. However, 62.5% of CRPs reported that < 11 patients participated in the last calendar year despite 88.5% reporting no limit to the number they could enroll. Among CRPs, 25% accepted only patients with concurrent cardiac diagnoses, living in the community (47.8%), and without severe mobility (70.1%), communication (80.6%), or cognitive (85.1%) deficits. The 2 most influential barriers and facilitators among all CRPs were funding and staffing. The fourth greatest barrier was lack of poststroke referrals, and third to sixth facilitators were SR/CRP collaboration to ensure appropriate referrals (third) and to increase referrals (sixth), toolkits for prescribing resistance (fourth), and aerobic training (fifth). CRP characteristics associated with accepting stroke were a hybrid program model, a medium program size, and having a falls prevention component. Conclusions Most CRPs accept patients poststroke, but few participate. Therefore, establishing SR/CRP partnerships to increase appropriate referrals, using a toolkit to help operationalize exercise components, and allocating funding/resources to CRPs may significantly increase access to secondary prevention strategies.

Purpose This study aimed to determine the magnitude of exercise-induced individual variability for waist circumference (WC) and body weight change after accounting for biological variability and measurement error. Determinants of response variability were also considered. Methods Participants (53 ± 7.5 yr) were 181 adults (61% women) with abdominal obesity randomized to the following: control; low-amount, low-intensity exercise (LALI); high-amount, low-intensity exercise (HALI); or high-amount, high-intensity exercise (HAHI) for 24 wk. Unstructured physical activity was measured by accelerometer. The variability in response to exercise for WC and body weight (SDR) was isolated by subtracting the SD values for the change scores in the exercise group from that of the control group. Results The variability of response due to exercise (SDR) for change in WC was 3.1, −0.3, and 3.1 cm for LALI, HALI, and HAHI groups, respectively. Corresponding values for body weight were 3.8, 2.0, and 3.5 kg for LALI, HALI, and HAHI, respectively. The high-amount exercise groups yielded the highest proportion of individuals with a clinically meaningful response. No variables predicted the response to exercise (P > 0.05). Conclusions Substantial variability in response to standardized exercise was observed for change in both WC and body weight after accounting for the variability not attributed to exercise. Potential determinants of the interindividual variability in response to exercise remain unclear.

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