Stroke Recovery Trial Participant Stroke Free for Six Years

Groundbreaking Cardiovascular Rehabilitation of Stroke Survivors (CROSS) trials at JFK Johnson Rehabilitation Institute transform woman's life

Mary Logan, 66, says she could have been “six-feet-under” without the groundbreaking Cardiovascular Rehabilitation of Stroke Survivors (CROSS) trials. Unlike traditional stroke rehabilitation, the trials’ innovative therapy approach includes aerobic conditioning similar to cardiac rehabilitation regimens.

Six years ago, Logan was among the first patients in the pioneering initiative at JFK Johnson Rehabilitation Institute that aims to fundamentally change rehabilitation for stroke survivors. Today, Logan works as an Uber driver.

The CROSS trials have found that stroke survivors who completed the program improved on every measure studied: reduced hospital readmissions, improved cardiac performance and improved overall function. Most strikingly, the program reduced the chances of death within one year after the stroke by 76 percent.

“I loved the program. It was fantastic,” Logan said. “People who have had a stroke can and should exercise. I found myself getting stronger and stronger all the time. I still exercise every day. The program really turned my life around.”

Logan experienced her stroke working as a waitress. One morning, she found herself feeling “pulled to the right. … I had to fight to go to the left.” She continued with her life, even working, until after three days she finally drove herself to the hospital just as she lost the use of her right arm, leg and shoulder.

She received emergency treatment and was then sent for acute in-patient rehabilitation at JFK Johnson Rehabilitation Institute, where she spent 10 days. But her recovery was not over. Her physicians suggested she consider the clinical trials examining the JFK Johnson Stroke Recovery Program.

The program includes 36 sessions of medically monitored interval cardiovascular training; follow-up visits with a Physical Medicine and Rehabilitation physician providing stroke-specific risk factor education such as smoking cessation and nutrition; and traditional stroke rehabilitation to address stroke-related issues.

The cardiovascular aerobic conditioning program is modified for stroke patients who may have problems with muscle movement, or plegia, because of their stroke. The participants are monitored, and encouraged, by a professional medical team.

Sara Cuccurullo, M.D., Medical Director of JFK Johnson, and Talya Fleming, M.D., Director of the Stroke Recovery Program & Aftercare Program, have been leading the research while advocating for more effective rehabilitation for stroke survivors. The JFK Johnson researchers are now in discussions with key rehabilitation hospitals across the country to expand the research nationally.

Currently, Medicare and other health care insurers typically provide coverage for a comprehensive cardiovascular aerobic conditioning rehabilitation program only for cardiac disease, but not for those recovering from a stroke. Dr. Cuccurullo and Dr. Fleming say data from the CROSS trials show stroke patients would greatly benefit from access to cardiovascular rehabilitation.

Logan was unaware at the time that her cardiovascular rehabilitation was groundbreaking and was not typically provided to stroke survivors. She recognizes that the cardiovascular interval training as well as all the support involved in her rehabilitation set her up for a healthier future.

“I think anyone who had a stroke should have the opportunity to benefit from this program,” she said.

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