Developing a Home Exercise Program After Therapy:
Although most stroke survivors will have some sort of initial therapy and rehabilitation program, it usually only lasts a few months. However, it's often beneficial to continue an exercise program after therapy has ended -- recent studies suggest exercise can improve cardiovascular fitness, sensory and motor functioning and overall health. Please keep in mind that any exercise program for a stroke survivor should be discussed with a medical doctor first.
Although most stroke survivors will have some sort of initial therapy and rehabilitation program, it usually only lasts a few months. However, it's often beneficial to continue an exercise program after therapy has ended -- recent studies suggest exercise can improve cardiovascular fitness, sensory and motor functioning and overall health. Please keep in mind that any exercise program for a stroke survivor should be discussed with a medical doctor first.
Post-Stroke Inactivity is a Vicious Cycle:
Only about 14 percent of stroke survivors achieve full recovery of their motor functions. The remaining 86 percent will have some issues. Hemiplegia can make walking very difficult, which can lead to the stroke survivor becoming less active. This can create a vicious cycle, where the effects of inactivity, such as muscle weakening and decreased cardiovascular capacity (in other words, becoming more "out of shape"), can lead to even further inactivity.
Only about 14 percent of stroke survivors achieve full recovery of their motor functions. The remaining 86 percent will have some issues. Hemiplegia can make walking very difficult, which can lead to the stroke survivor becoming less active. This can create a vicious cycle, where the effects of inactivity, such as muscle weakening and decreased cardiovascular capacity (in other words, becoming more "out of shape"), can lead to even further inactivity.
In addition to worsening their depression, which is very common in stroke survivors, inactivity can cause or contribute to many physical complications, including osteoporosis and decreased circulation in the legs and feet. This can lead to skin ulcers and can cause blood clots to form.
Inactivity also can cause the sedentary stroke survivor to gradually become more and more dependent on others, which can have many negative psychological effects, including depression, social isolation and a diminished self worth.
Get Moving:
The American Heart Association (AHA) recommends a regular exercise program for stroke survivors. While they have outlined specific recommendations, they do caution that every patient is different and each individual’s exercise program should be developed in consultation with their doctor.
The American Heart Association (AHA) recommends a regular exercise program for stroke survivors. While they have outlined specific recommendations, they do caution that every patient is different and each individual’s exercise program should be developed in consultation with their doctor.
Before You Begin:
The AHA recommends a complete medical evaluation before beginning an exercise program. This may even include an exercise stress test if the patient has known or suspected heart disease.Aerobic Exercise:
The AHA recommends that stroke survivors receive 20 to 60 minutes of aerobic exercise three to seven days a week.
The AHA specifically recommends walking on a treadmill for aerobic exercise, and special modifications, such as adding handrails or harnesses, may be needed. Treadmill-based exercise is strongly suggested because walking is required for everyday living and patients who walk slowly can increase the intensity of their workout by adjusting the grade of the treadmill.
The AHA recommends that stroke survivors receive 20 to 60 minutes of aerobic exercise three to seven days a week.
The AHA specifically recommends walking on a treadmill for aerobic exercise, and special modifications, such as adding handrails or harnesses, may be needed. Treadmill-based exercise is strongly suggested because walking is required for everyday living and patients who walk slowly can increase the intensity of their workout by adjusting the grade of the treadmill.
Strength Training :
Because muscle weakness is common after a stroke, the guidelines also recommend strength training with resistance or light weights two to three times per week. The program should include 10 to 15 repetitions of eight to 10 different exercises that involve major muscle groups.
Because muscle weakness is common after a stroke, the guidelines also recommend strength training with resistance or light weights two to three times per week. The program should include 10 to 15 repetitions of eight to 10 different exercises that involve major muscle groups.
Stretching and Flexibility Exercises :
Because many stroke survivors have difficulty raising their arms and moving their legs, stretching and flexibility exercises are also recommended. The recommended frequency for stretching is two to three times per week performed either before or after the aerobic or strength training exercises.
Because many stroke survivors have difficulty raising their arms and moving their legs, stretching and flexibility exercises are also recommended. The recommended frequency for stretching is two to three times per week performed either before or after the aerobic or strength training exercises.
Balance and Coordination Exercises:
Stroke survivors are at an increased risk for falls because of balance problems and should have two to three sessions each week of balance or coordination exercises.
Stroke survivors are at an increased risk for falls because of balance problems and should have two to three sessions each week of balance or coordination exercises.
Preventing a Repeat Stroke:
Not only can regular physical exercise improve the quality of life for stroke survivors by increasing their strength and mobility, it can also reduce their risk for a repeat stroke and a heart attack.
Depression is common after a stroke and can become worse with social isolation. Leaving home to participate in an exercise program can help lessen feelings of isolation.
If they cannot leave home easily and cannot exercise independently, a personal trainer can be hired to come into the home. A trainer can come for every session or could just come long enough to train the patient and their caregiver(s) in their exercise routine.
Source:
Neil F. Gordon, Meg Gulanick, Fernando Costa, Gerald Fletcher, Barry A. Franklin, Elliot J. Roth, and Tim Shephard, "Physical Activity and Exercise Recommendations for Stroke Survivors: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council." Circulation 109(2004) 2031-2041. 26 OCT 2006 <http://circ.ahajournals.org/cgi/content/full/109/16/2031>.
Not only can regular physical exercise improve the quality of life for stroke survivors by increasing their strength and mobility, it can also reduce their risk for a repeat stroke and a heart attack.
Where to Exercise:
Some stroke survivors may be able to safely and comfortably exercise at home. For others, participating in a local program may be the best choice. If they have trouble remembering, following directions or speaking, they may be more likely to participate and continue in exercise if they leave home to participate in a program.Depression is common after a stroke and can become worse with social isolation. Leaving home to participate in an exercise program can help lessen feelings of isolation.
If they cannot leave home easily and cannot exercise independently, a personal trainer can be hired to come into the home. A trainer can come for every session or could just come long enough to train the patient and their caregiver(s) in their exercise routine.
Finding a Program:
There may be post-stroke exercise programs available in your community. A program will provide a safe environment in which to exercise and will provide social interaction with other stroke survivors. Places to look for programs are at YMCAs and local gyms. Also, some outpatient therapy centers have a post-rehab stroke programs.Source:
Neil F. Gordon, Meg Gulanick, Fernando Costa, Gerald Fletcher, Barry A. Franklin, Elliot J. Roth, and Tim Shephard, "Physical Activity and Exercise Recommendations for Stroke Survivors: An American Heart Association Scientific Statement From the Council on Clinical Cardiology, Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention; the Council on Cardiovascular Nursing; the Council on Nutrition, Physical Activity, and Metabolism; and the Stroke Council." Circulation 109(2004) 2031-2041. 26 OCT 2006 <http://circ.ahajournals.org/cgi/content/full/109/16/2031>.
