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 In a scientific statement from the American Heart
Association and the American Stroke Association, they write that
both aerobic exercise and strength training may help stroke
survivors keep up their daily activities and improve their quality
of life.
Becoming more active may also lower their risk of having a heart
attack or a second stroke, but that remains to be shown
definitively.
“Physical activity really has to be at the base of any sort of
recommendation post-stroke,” said James Rimmer, from the University
of Alabama at Birmingham and the Lakeshore Foundation.
Rimmer was not involved in writing the scientific statement, but has
studied the effects of exercise after stroke.
About 795,000 people in the U.S. have a stroke every year, the
authors of the report note. Most of them survive, but with some
stroke-related impairment. Many people who have had a stroke also
have other co-occurring health problems.
For those reasons and others - including a lack of support - stroke
survivors typically don’t get much exercise, according to the
statement. But being sedentary can only compound some of their
symptoms, like fatigue and declining fitness.
The statement is an update to a 2004 document that also recommended
people be more active after a stroke. Now, the authors are even more
confident in that prescription, said Sandra A. Billinger, of the
University of Kansas Medical Center in Kansas City.
She and her colleagues outline the importance of physical activity
soon after a stroke and as part of a permanent lifestyle change.
Within the first 24 hours after a stroke, patients should try
getting out of bed and moving around, they write. As the recovery
process goes on, adding more movement will help them get back to
performing daily activities. Ultimately, people who have had a
stroke and are capable of exercise should aim for at least three
days a week of aerobic activity, such as on a treadmill or
stationary bike, and two to three days a week of resistance
training.
One of the key times for patients to stay active is when their
stroke rehabilitation program is wrapping up, Billinger said. It can
be intimidating, she said, to go from working one-on-one with a
physical therapist to exercising in a gym, for instance.
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“There’s a gap after rehabilitation in the U.S. specifically,” she
told Reuters Health. “We haven’t quite bridged that as well as some
of the other countries.”
The authors note that evidence is lacking on how to encourage
activity among people who can’t walk after a stroke or who have
trouble communicating.
Any guidance should be tailored to the needs of a particular
patient, they add.
Rimmer agreed. “Exercise really needs to be as individualized as
medication,” he said.
He told Reuters Health that recumbent steppers can be an option for
people with more limited mobility, because they are easy to get on
and off and are very safe.
More research is needed to help find the optimal dose of exercise to
lower the risk of falls or second strokes, for instance, Rimmer
said.
Billinger said patients should talk with their doctor before
starting any intensive exercise. She emphasized that for people who
are limited in their exercise capabilities, even walking back and
forth to the mailbox a few times a day is a good start.
“Anything to get them moving is better than nothing,” she said.
SOURCE: http://bit.ly/1m4EODH Stroke, online May 20, 2014.
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