Regular physical activity should be recommended to all individuals affected by or at risk of stroke. Exercise can be used as an effective tool for primary and secondary prevention of chronic disease and has the capacity to mitigate symptoms and help individuals achieve meaningful outcomes. A combination of aerobic, resistance and neuromuscular exercise can positively influence quality of life, activities of daily living, emotional wellness, physical function and overall independence during stroke rehabilitation. Research suggests that regular physical activity can reduce an individual’s risk of initial or recurrent stroke, manage side-effects and improve post-stroke recovery.
What is stroke?
A stroke will occur when the blood supply to the brain is limited, resulting in a lack of oxygen in the brain. The longer the brain is starved of oxygen, the greater the damage. There are two types of stroke:
1. Ischaemic – reduced blood flow to the brain as a result of blocked arteries
2. Haemorrhagic – arteries in the brain burst, causing a leakage of blood into the brain
Both types of stroke have similar side-effects; however these vary depending on the region of the brain affected. Common side-effects include:
· Muscle weakness or paralysis in the legs and/or arms
· Sensory deficits
· Cognitive deficits
· Perceptual deficits
· Loss of balance
What can we do?
Over half a million Australians are living with the effects of stroke, however according to the Stroke Foundation Australia; more than 80% of strokes are preventable. Common modifiable risk factors that predispose individuals to stroke include:
· High blood pressure
· High cholesterol
· Excessive alcohol intake
· Physical inactivity
· Being overweight
· Poor diet
The role of physical activity
Regular exercise can not only reduce an individual’s risk of stroke (by addressing the modifiable risk factors), it is a significant tool in rehabilitation post stroke. As each person presents differently, it is important that treatment plans are individualised and take into consideration the individual’s goals and concerns and the severity of their condition. A combination of aerobic, resistance and neuromuscular exercises will form the basis of a treatment plan.
1. Cardiovascular exercise:
· Aims to increase an individual’s tolerance to regular movement and improving their aerobic capacity.
· Initially an individual should start at a level they can tolerate and slowly increase the time and frequency so they are achieving at least 3-5 days of moderate to high intensity exercise per week.
2. Resistance training:
· Aims to improve an individual’s overall muscular activation, strength and endurance to ensure they are achieving an appropriate level of independence in regards to their activities of daily living, goals and concerns.
· Resistance exercises should be completed at least twice a week.
3. Neuromuscular exercise:
· Incorporating balance and coordination activities into a program aims to improve an individual’s gait biomechanics, walking speed, reduce falls risk and ability to navigate obstacles, stairs and slopes.
· Neuromuscular exercises should be performed at least twice a week.
80% of stroke survivors will experience physical / movement deficits, become deconditioned, are predisposed to a sedentary lifestyle and are at risk of recurrent stroke. Therefore exercise programs need to focus on promoting regular physical activity and reducing time spent sedentary. Seeking the guidance of an accredited exercise physiologist, who has expert knowledge of stroke and the associated risk factors and side-effects, will ensure a safe and effective treatment plan is put in place.