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Stroke Smart Magazine

March/April 2007

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Improve Recovery With Exercise

By Pete Lewis

Everyone knows that exercise is good for your health. But now there is evidence that regular exercise can improve stroke recovery, even years after a stroke.

Right after a stroke, rehabilitation usually focuses on helping the survivor regain the use of an arm or leg, or relearn other abilities affected by the stroke. Therapy can be intense and usually lasts several months. A significant amount of recovery occurs during this time. And until recently, many believed that a survivor could expect little improvement afterwards. It is now known that with a combination of repetition therapy and cardiovascular exercise, recovery can continue for years.

Cardiovascular fitness is the medical term for our body's ability to transport the oxygen we breathe, through our bloodstream, to the various organs of our bodies. Cardiovascular fitness decreases with inactivity and improves with activity and exercise.

Many stroke survivors had poor cardiovascular health before their strokes. Their condition often declines further after stroke because they are even less active. But a modest exercise program can improve cardiovascular health in stroke survivors and decrease their chances of having another stroke or heart disease, the two leading causes of death among stroke survivors.

“Stroke is defined as a disease of the brain, but poor cardiovascular health is often why they had a stroke in the first place,” said Dr. Carolee Winstein, director of the Motor Behavior and Neurorehabilitation Laboratory at the University of Southern California. “An exercise program that increases stroke patients' physical fitness can decrease their chances of having another stroke, enhance their recovery and improve their quality of life.”

Exercise can help stroke survivors manage their weight, improve their cholesterol levels, and increase strength, flexibility and endurance. Exercise also can build a stroke survivor's confidence and help with depression. Walking is often the best choice of exercise for stroke survivors, especially those whose ability to walk was affected by a stroke. That's because walking improves cardiovascular fitness and involves repetition. For many stroke survivors, it is safest to begin walking on a treadmill with handrails.

However, before you start any exercise program, it is essential to first be checked out by a doctor and to follow a plan developed by a health professional.

“You should not be doing this on your own,” Winstein said. “You need someone who is knowledgeable about stroke risk and rehab. You're not going to find that at your local gym.”

Dr. Richard Macko, professor of neurology at the University of Maryland Medical Center, has studied the benefits of treadmill training for stroke survivors who have trouble walking. His average patient had a stroke three years prior to the study. At the start of the study, some patients required support and could only walk for three minutes at a time, at one-tenth the speed of a healthy adult. Over six months, training was increased to three 40-minute sessions per week.

After six months of treadmill training, the patients in Macko's study showed significant improvements in physical fitness and walking ability.

“Many stroke survivors may think that their window (for recovery) may end three months after their stroke, but our research and other research has shown that with structured exercise and repetition, a stroke patient can continue to improve,” Macko said. “Even a decade after their stroke, patients can fight back against the disabilities associated with their disease.”


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.

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