Stroke and Exercise

What is a stroke?

A stroke occurs when the blood supply to the brain is suddenly interrupted which may lead to temporary or permanent damage to the brain. There are the two main causes and types of strokes. Firstly, the most common is an ischemic stroke which accounts for 80% of total strokes and occurs when an artery in the brain is blocked by a clot, stopping normal blood flow and the delivery of oxygen to the brain area. The second cause is through a break in the wall of a blood vessel which leads to bleeding in the brain and is classified as a haemorrhagic stroke.

What are common symptoms associated with a stroke?

Symptoms that individuals present with after suffering a stroke can vary significantly. The range of symptoms may include:

  • weakness and/or numbness of the face, arm or leg on either side of the body. One sided-weakness or paralysis typically occurs on the opposite side of the body to which the stroke occurs in the brain.
  • Loss of balance, falling and/or increased dizziness
  • Increased fatigue
  • Difficulty speaking or comprehending others
  • Difficulty thinking and/or memory loss
  • Blurred or reduced vision in one or both eyes
  • Difficulty swallowing

Symptoms can appear alone or in combination and last for hours, days, months, or even years. If symptoms go away within 24 hours, this is usually called a transient ischemic attack (TIA). A TIA should not be ignored. Investigating the cause of a TIA and subsequent management of any risk factors may prevent a stroke. The degree of recovery and the speed of recovery from stroke varies between individuals and recovery may take many years.

How do you know if someone is having a stroke? Think… F.A.S.T.

The Stroke Foundation recommends the F.A.S.T. test as an easy way to remember the most common signs of stroke. Using the F.A.S.T. test involves asking these simple questions:

  • Face Check their face. Has their mouth drooped?
  • Arms Can they lift both arms?
  • Speech Is their speech slurred? Do they understand you?
  • Time Is critical. If you see any of these signs call 000 straight away.

How does exercise help with a stroke?

Physical activity levels are reported to be very low in stroke survivors due to increased symptoms experienced post-stroke. However, once a person is affected by a stroke, regular exercise is vital in reducing the risk of further strokes, improve post-stroke recovery and achieve a range of benefits including:

  • Improved walking ability, functional capacity and ability to complete day-to-day tasks
  • Decreased falls risk and improved confidence
  • Improved ability to return to leisure activities
  • Improved muscle strength, endurance and fitness
  • Improved balance and coordination
  • Improved flexibility
  • Improved mood and quality of life
  • Improved cognitive functioning and thinking ability
  • Reduced blood pressure and cholesterol

What exercise is best for people who have suffered a stroke?

The type of exercise or physical activity that works best for an individual with stroke will depend on the extent of their symptoms, any other medical conditions they may have such as heart problems and diabetes, their exercise preferences, and their ability to get out and about. Fatigue is often reported as a barrier to exercise, but there is some evidence that exercise can help, so people with stroke, including those with fatigue, should try to find ways to participate in regular exercise or physical activity.

Cardiovascular Fitness and Endurance Exercises (Aerobic)

  • Aim to complete 3-5 days per week and work up to 20-60 minutes per session
  • Can be performed in a variety of settings including home, gym, hydrotherapy and community areas
  • Modes of exercise can include cycling, leg or arm ergometry, elliptical trainers, walking on a treadmill or outside, climbing stairs, swimming, etc
  • Initially aim to start working at a light-intensity (2/10 RPE) and work up to moderate-intensity (3-5/10 RPE) as tolerated.
  • Short, frequent bouts of exercise have been shown to be very beneficial in this population – the beneficial effects of exercise are cumulative and doing some exercise is better than none!

Strengthening/Resistance Exercises

  • Can be performed at home, in a community centre, at a rehabilitation setting, or local gym.
  • Resistance training of arms, legs and trunk can be achieved using free weights, weight-bearing or partial weightbearing activities, machine weights, elastic bands, spring coils or pulleys.
  • Progressive resistance training with heavy weights and low repetitions are valuable.
  • 2-3 days a week; alternate muscle groups if you do strengthening exercises more regularly

Finding the right type of exercise for you

A typical exercise session looks different for different people. It will depend on what you enjoy, what you’re capable of, and what your fitness and mobility goals are.
There are barriers to exercise for everyone, but even more so after having a stroke and these can include your level of physical ability, changes to thinking, memory and mood, fatigue, loss of confidence, lack of money, and a lack of support. The wonderful thing is that exercise can improve most of these barriers!

How we as Accredited Exercise Physiologists can help you!

Always consult an Accredited Exercise Physiologist who can develop a tailored exercise plan to suit your needs.

Accredited Exercise Physiologists can help you address these barriers and get started on a program that works best for you. Our Exercise Physiologists have experience working with stroke survivors and helping them reach their goals and improve their functional capabilities.

Stroke survivors with significant limitations may benefit from being referred to a Neurological Physiotherapist who have advanced training and experience. Exercise is safe to perform after having a stroke, however, before commencing a cardiovascular fitness training program, a medical review with your doctor is recommended to discuss clearance.

Get in touch with us via our contact us page on our website to find out how we can help you or someone you know today!

By Brodie Nathan