Wednesday, May 21, 2014

Activity and Exercise Post Stroke

The AHA/ASA just released information and recommendations about physical activity and exercise after stroke.

The full article from the journal Stroke can be reached here:

After stroke, decreased physical activity, exercise, and life participation is common. This article provides guidelines for activity and exercise prescriptions post stroke. Highlights:
- Should be personalized.
- Prescription should be of safe dosage (frequency, intensity, time, type) for each individual.
- Should minimize bed rest during acute and inpatient rehab phase. At the very least, stroke patients should sit and stand at regular intervals during day.
- After medically stable, exercise schedules should meet or exceed prestroke activity/exercise levels.
- OT/PT should also include cardiovascular and strengthening exercises.
- Aerobic exercise is recommended (treadmill, cycling, stepper, water aerobics, etc.)
- Think ahead to ensure exercise and activity levels can be maintained over time
- Barriers: depression, fatigue, low interest/motivation, low self-efficacy, fear, lack of support, lack of awareness, cost, transportation, embarrassment, other health problems, fear of recurrent stroke
- Motivators/moderators: social support/social networks with other stroke survivors, professional support, group exercise classes, desire to independently perform ADLs, possibility of functional benefit (e.g., driving), enhance confidence,

"On the basis of the available evidence, it is recommended that stroke survivors undertake regular aerobic exercise to increase aerobic capacity and improve gait efficiency, thereby reducing fall risk and enhancing functional independence, as well as reducing the risk of recurrent cardiovascular events. In addition, resistance (strength) training is advocated to increase independence in activities of daily living, flexibility training to increase range of movement and prevent deformities, and neuromuscular training to enhance balance and coordination." (p. 8)

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