Exercising Following a Stroke: Prescription for Health

American College of Sports Medicine

March 31, 2010

Introduction

A safe and effective exercise program is an important part of the rehabilitation process following a stroke. Regular physical activity can help improve your balance and coordination, reduce the need for assistive devices, and enhance your general quality of life. And, perhaps most importantly, exercise may reduce the risk of having another stroke. The key is to determine what type of exercise is best for you and to follow a program that fits your specific needs.

Getting Started

  • Talk with your health care provider and rehabilitation therapist about integrating regular exercise into your treatment plan.

  • Take all medications as recommended by your physician.

  • The goals of your program should be to improve mobility and overall fitness, and to reduce risk factors, such as high blood pressure, that can lead to future strokes.

  • Choose activities that are comfortable and well-tolerated, such as chair-based or water exercises or recumbent cycling.

  • Exercises that emphasize straightening and rotating your spine will help improve overall strength and posture as well as helping you do daily tasks.

  • Start slowly and gradually progress the intensity and duration of your workouts. Closely monitor your intensity level and stay within the target heart-rate range prescribed by your health care provider.

  • Ask your physician how the medications you take influence your heart rate and blood pressure so you know what numbers are right for you during exercise.

  • Aim to exercise three to five times per week.

  • Shorter periods of exercise throughout the day (5-10 minutes at a time) can add up to help you achieve the amount of exercise you need.

  • Exercise equipment may need to be modified to accommodate your specific needs.

Exercise Cautions

  • Always check with your physician prior to increasing your activity level.

  • Reduced motion and control of your limbs may restrict your ability to do certain exercises.

  • Avoid exercises that overload your joints or increase your risk of falling. Begin each exercise in a stable position and note your response before proceeding. Mild-moderate muscle soreness for 24 hours after exercise is normal. Extreme pain or pain following exercise usually indicates the need to decrease the intensity of the workout and gradually increase activity more slowly.

  • Avoid holding your breath during strength training because this can cause large fluctuations in blood pressure. During aerobic activity, like walking or cycling, you should be able to talk or sing during your exercises.

  • Don't hesitate to ask for demonstrations or further explanations about how to perform exercises properly. Have your fitness professional watch you do the exercise to assure that you are doing it correctly in a safe and effective manner.

Your exercise program should be designed to maximize the benefits with the fewest risks of aggravating your health or physical condition. Consider contacting a certified health and fitness professional* who can work with you and your health care provider to establish realistic goals and design a safe and effective program that addresses your specific needs.

For more information, visit www.exerciseismedicine.org or e-mail eim@acsm.org.

* If your health care provider has not cleared you for independent physical activity and would like you to be monitored in a hospital setting or a medical fitness facility, you should exercise only under the supervision of a certified professional. The American College of Sports Medicine (ACSM) has two groups of certified fitness professionals that could meet your needs. The ACSM Certified Clinical Exercise Specialist (CES) is certified to support those with heart disease, diabetes and lung disease. The ACSM Registered Clinical Exercise Physiologist (RCEP) is qualified to support patients with a wide range of health challenges. You may locate all ACSM-certified fitness professionals by using the ProFinder at www.acsm.org.

Sources: ACSM’s Guidelines for Exercise Testing and Prescription and other ACSM publications.

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