Current Exercise Prescriptions for Stroke Survivors

The health and wellness benefits of exercise are widely known in the allied health profession community. However, the development of exercise prescription is complicated. It contains a multistep process that must account for the individual’s pre-exercise health screening, fitness testing, and must incorporate the FITT principle (frequency, intensity, type, and time). This process only becomes more complicated as special populations are considered.

According to Ammann et al. (2014), stroke is one of the leading causes of death and disability in the world.1 In an article published by the American Heart Association in early 2014, almost 800,000 Americans each year experience a stroke and there are an estimated 7 million stroke survivors alive today.2 Clearly, there is a large population of individuals in America that need special attention for their exercise prescription.

The current exercise prescription recommendations of stroke survivors include both aerobic and resistance training but must be specific to the target population.1,2 Benefits of exercise have been seen for both sub-acute and chronic stroke survivors.1,2 Ammann et al. (2014) emphasizes the importance of the training principle of reversibility, such that conditioning and deconditioning can be reversed.1

Aerobic exercise training, such as treadmills with or without body weight support, lower or upper extremity cycle ergometers, and recumbent steppers, are incorporated in most exercise prescriptions with the intention of developing optimal functional motor performance.1 Participation should be at least three days per week, with a duration between 20 and 60 minutes. However, more frequent shorter bouts can be effective if functional ability does not allow for a single longer workout.2

Building muscular strength and endurance is typically accomplished through resistance training of the upper and lower extremities using free weights and either weight-bearing or partial weight-bearing activities.1 High repetition sets, between 10 to 15 repetitions, are beneficial when performed two to three times per week with at least eight different exercises involving major muscle groups.

Aside from aerobic and resistance training, a more unconventional method for neuromuscular exercise has been discussed.2 Using interactive and active-play video games, such as Wii Sports and Wii Fit Plus, require both upper and lower extremity exercise and are also quite enjoyable for many participants.2

 

1 Ammann, B. C., Knols, R. H., Bashung, P., de Bie, R. A., & de Bruin, E. D. (2014). Application of principles of exercise training in sub-acute and chronic stroke survivors: A systematic review. BMC Neurology , 14 (167).

2 Billinger, S. A., Arena, R., Bernhardt, J., Eng, J. J., Franklin, B. A., Johnson, C. M., et al. (2014, May 20). Physical activity and exercise recommendations for stroke survivors: A statement for healthcare professionals from the American Heart Association/American Stroke Association. AHA Journal , 2533-2553.