Benefits of exercise after stroke
Posted on 23 March 2012
The use of exercise has multiple advantages for those affected by stroke.
What is a stroke
A stroke, or brain attack, occurs when blood flow to the brain is interrupted or severely limited, cutting off oxygen and nutrients from brain tissue.
Types of stroke
There are two broad categories of strokes, namely an ischaemic stroke and a haemhorragic stroke. An ischaemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. A haemhorragic stroke occurs when a weakened blood vessel ruptures. Although they are less common, they are more deadly.
Risk of stroke
A health risk appraisal function has been developed for the prediction of stroke using the Framingham Study cohort. The stroke risk factors included in the profile are age, systolic blood pressure, the use of antihypertensive therapy, diabetes mellitus, cigarette smoking, prior cardiovascular disease (coronary heart disease, cardiac failure, or intermittent claudication), atrial fibrillation, and left ventricular hypertrophy by electrocardiogram. Living a healthy lifestyle can reduce your risk of developing a stroke. This includes following a healthy low fat, low cholesterol, low salt diet, exercising regularly, smoking cessation, and monitoring your blood pressure and cholesterol regularly.
Complications following a stroke
Stroke is the most common disabling neurological condition in adults. 90% of people living with stroke have some functional limitations. These include muscle weakness, pain, spasticity, cognitive dysfunction, and frequent falls. Other common complications are post-stroke depression, poor balance, lower bone mass in the affected arm or leg, and poor mobility. These impairments can lead to reduced activity and sedentary lifestyles, with further declines in function and disability status. Stroke has direct and/or secondary effects on the major aspects of health (physical, physiological and social). It is important to preserve both functioning and well-being of people with stroke.
Rehabilitation following a stroke
The purpose of a formal rehabilitation program is to assist in and accelerate the recovery process of stroke patients. The body is most receptive to the beneficial impact of physical and other rehabilitative therapies during the first six months after a stroke, so that’s when a concentrated effort is usually made to reverse the neurological malfunctioning and, in doing so, eliminate disability. The patient and family members work closely with a stroke rehabilitation team of physicians; specially trained nurses; physical, occupational, and speech therapists; and biokineticists.
Benefits of exercise
The use of exercise has multiple advantages for those affected by stroke. These advantages include improving one's psychological and emotional well-being, increasing physical fitness, reducing the degree of disability and improving self-esteem. It has been shown that there is theoretical and empirical benefits of aerobic exercise after stroke. Moderate and high levels of physical activity have been showed to be associated with reduced risk of ischemic and hemorrhagic stroke.
Exercise is a treatment modality that has been typically used during stroke recovery to improve motor function. Falls and poor mobility are major contributors to stroke-related disability. There is good evidence that exercise can enhance mobility after stroke. A large proportion of people living with stroke are able to regain standing and some walking function. A number of randomised controlled exercise interventions in people with stroke have resulted in improvements in fall risk factors demonstrated by outcomes such as balance, weight-bearing ability, gait and mobility. Improving balance function is a major focus of stroke rehabilitation. Exercise improves balance and therefore it is an important modality that can reduce multiple fracture risk factors and should be considered for the management of falls. People with stroke who have fallen previously have more fear of falling which reduces confidence in one's abilities.
Physical inactivity has long been identified as a risk factor for osteoporosis. Increasing physical activity through specific exercise training may therefore be an effective strategy for enhancing bone health and maintenance of bone mass following a stroke. The combination of muscle loading and ground reaction forces produced during exercise may provide the mechanical strain necessary for enhancing bone mass.
The major burden of stroke is chronic disability rather than death. Exercise has been used to improve cardiovascular health in the attempt to reduce secondary complications such as recurrent stroke and heart disease. On completion of rehabilitation most stroke survivors can walk independently, however 90% of these people are unable to walk with sufficient speed or endurance to function effectively in the community, and 70% of stroke survivors will fall within six months of discharge from hospital. Exercise programs which specifically target balance and lower limb muscle strength are effective in preventing falls. There is good evidence that well-designed exercise programs can enhance functional abilities after stroke.
Sudden death during exercise and musculoskeletal injuries are risks for Stroke patients while exercising. It is very important for those affected by stroke to be evaluated by a Biokineticist before commencing with exercise. This will allow a stroke patient to exercise safely.
- Shamay, S.M (2009). Does the use of TENS increase the effectivenss of exercise for improving waling after stroke? A randomized controlled clinical trial. Clinical rehabilitation; 2-3: 1093-1103.
- Dean, C.M., Rissel, C., Sharkey, M., Sherrington, C., Cumming, R.G., Barker, R.N., Lord, S.R., O’Rurke, S.D., Kirkham, C (2009). Exercise intervention to prevent falls and enhance mobility; community dwellers after stroke; a protocol for a randomized controlled trial. BMC Nuerology; 9:38
- Holmgren, E., Crosman-Hedstrom, G., Lindstrom, B., Wester, P (2010). What is the benefit of a high-intensive exercise program on health-related quality of life and depression after stroke? A randomized controlled trial. Advances in Physiotherapy; 12:125-133
- Eng, J.J., Pang, M.Y.C., Ashe, M.C (2008). Balance, falls, and bone health: Role of exercise in reducing fracture risk after stroke. Journal of rehabilitation research and development; 45 (2):297-314
For more information about Stroke Rehabilitation, please contact:
Institute for Sports Research
012 420 6033
or visit our website @ www.isr.co.za