Category: Topic Loops

• Sedentary behaviours complicate the recovery process and affect risk of recurrence. It is a challenge to establish a safe therapeutic exercise regimen to firstly regain previous stroke activity and secondly to reach sufficient activity to reduce stroke risk. Activities should be matched to ability, interests and availability.
• Find out what is available in your area and be creative!
  • Bums off seats / seated exercise / bowls / golf / dancing / tai chi/ yoga / walking / cycling / gardening
  • Think about types of activity for stamina, strength and flexibility and mobility (see CHSS leaflet )
  • Application of Wii-Fit (Wii-Hab)
• Barriers to activity:
  • Lack of interest, social support, time, opportunity, transportation, financial means
  • Physical difficulties including paresis, shortness of breath, joint pain
  • Dislike going out alone
  • Perceived lack of fitness
  • Lack of energy
  • Doubting that exercise can lengthen life and lack of knowledge that exercise is beneficial to health
• There can be many barriers to people participating in activity. Think about using brief interventions to identify what might be suitable. Try to offer alternative types of physical activity.

Physical fitness – a set of attributes which people have or achieve that confers the ability to perform physical activity

• Physical fitness is important for the performance of everyday activities. The physical fitness of stroke patients is impaired after their stroke and this may reduce their ability to perform everyday activities and exacerbate any stroke-related disability.
• In theory physical fitness training after stroke may:
  • Improve function
  • Reduce disability
  • Improve quality of life
  • Improve mood
  • Reduce fatigue
  • Reduce the risk of falls
  • Improve vascular risk factors and so reduce risk of recurrent stroke and death
• Aim for at least 150 minutes (2 ½ hours) of moderate physical activity a week. For example, 30 minutes on 5 or more days, or a few sessions each day of 10 minutes at a time. Or
  You could do 75 minutes of vigorous activity a week instead. Moderate activity is activity that increases your breathing and heart rate. It makes you feel warm but you are still able to talk. For example, swimming, walking quickly, cycling. Vigorous activity is activity that makes your breathing fast and talking difficult. For example, running, playing sport, hiking uphill. For more information see  CHSS: Physical Activity.

• There is substantial evidence to support the beneficial effect of regular physical activity on risk factors for stroke including hypertension, glucose intolerance, low density lipoprotein cholesterol concentrations and obesity.
• Physical activity may reduce the risk of stroke (both ischaemic and haemorrhagic) and is an important modifiable risk factor (this evidence was in relation to primary prevention but it is reasonable to extrapolate from this that there will be a secondary prevention effect).
• There is a direct and dose respondent relationship between blood pressure and stroke risk.
• Activity helps to lower BP and improve lipid profiles, improve endothelial function and vasodilation and reduces blood viscosity, fibrinogen levels and platelet aggregability.
• Moderately active people have 20% lower risk of stroke.
• Highly active people have 27% lower risk of stroke.

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