(RxWiki News) Although a stroke can limit a person’s ability to move, many who have had a stroke can still join in physical activities. Exercise can improve their fitness and prevent stroke from recurring.
While stroke is a leading cause of long-term disability, inactive habits can worsen a patient’s condition and slow recovery.
Stroke survivors should be prescribed regular exercise, and healthcare professionals need to make more efforts to include physical activity into post-stroke care, according to a scientific statement issued by the American Heart Association and American Stroke Association.
"Exercise regularly to lower risks after stroke."
Sandra A. Billinger, PhD, assistant professor in the Department of Physical Therapy and Rehab Science at the University of Kansas Medical Center in Kansas City, chaired the committee of healthcare experts who wrote this practitioner guide to understanding the benefits of exercise for stroke patients and prescribing activity for any stage of recovery.
The authors acknowledged that stroke survivors face many obstacles when it comes to being active. These obstacles include stroke severity, tiredness, depression, lack of support, cost and motivation.
Dr. Billinger stressed, however, that exercise benefits can be great. She said that there is strong evidence that exercise can enhance heart health, walking ability and upper arm strength.
She also pointed out the potential mental and emotional gains that physical activity can have in terms of depression, clarity of thought, memory and quality of life.
Not enough healthcare providers, however, are prescribing exercise as part of post-stroke treatment, according to the investigators. They encourage these providers to help stroke patients gain the skills and confidence they need to maintain an exercise program that includes aerobic exercise and strength training.
“There is a big gap in America between once stroke patients are discharged from rehabilitation and the transition to community exercise programs when they go home,” Dr. Billinger said in a press release. “Many are left on their own. We don't have a system in place to help stroke patients feel comfortable with exercise."
As far as types of exercise that stroke survivors might try, she told dailyRx News that treadmill walking can be great therapy.
“If balance is an issue, there are other devices such as stationary cycles or recumbent steppers,” Dr. Billinger said in an interview with dailyRx News. “Muscle strength is important for many functional activities such as walking or carrying groceries. Therefore, strength training should be included in stroke care. Depending on the individual’s level of fitness, free weights or strength machines can be used to improve muscular strength.”
In the big picture, guideline authors urge survivors to work out at least three days a week for 20 to 60 minutes, depending on their capabilities. Many stroke survivors may better tolerate moderate-intensity sessions of 10 to 15 minutes.
More specific suggestions for providers are to tailor exercise regimens to the individual, taking into consideration stage of recovery, support, limitations and preferences. They should also keep bed rest to a minimum in the days immediately following a stroke (even standing occasionally can be beneficial). Furthermore, providers are urged to take advantage of existing rehabilitation programs that offer aerobic exercise, strength training, balance and flexibility.
“I think [healthcare providers] have been hesitant to prescribe exercise because it wasn’t as clear when to start activity, how much exercise is recommended and what types are beneficial,” Dr. Billinger told dailyRx News. “I hope that these updated guidelines will help healthcare professionals regularly incorporate exercise into stroke recovery.”
This statement was published in the American Heart Association journal Stroke in May, which is American Stroke Month.