Clinical Evidence of Exercise Benefits for Stroke

Abstract

Even though stroke is the third, not the first, most common cause of disability-adjusted life years in developed countries, it is one of the most expensive to treat. Part of the expense is due to secondary problems in the post-stroke period including: cognition, memory, attention span, pain, sensation loss, psychological issues, and problems with mobility and balance. Research has identified that exercise has both positive physical and psychosocial effects for post-stroke patients. Therefore, this scientific statement provides an overview on exercise rehabilitation for post-stroke patients.We will use systematic literature reviews, clinical and epidemiology reports, published morbidity and mortality studies, clinical and public health guidelines, patient files, and authoritative statements to support this overview.Evidence clearly supports the use of various kinds of exercise training (e.g., aerobic, strength, flexibility, neuromuscular, and traditional Chinese exercise) for stroke survivors. Aerobic exercise, the main form of cardiac rehabilitation, may play an important role in improving aerobic fitness, cardiovascular fitness, cognitive abilities, walking speed and endurance, balance, quality of life, mobility, and other health outcomes among stroke patients. Strength exercise, included in national stroke guidelines and recommended for general health promotion for stroke survivors, can lead to improvements in functionality, psychosocial aspects, and quality of life for post-stroke patients. Flexibility exercises can relieve muscle spasticity problems, improve motor function, range of motion, and prevent contractures. Stretching exercises can also prevent joint contractures, muscle shortening, decrease spasticity, reduce joint stiffness and improve a post-stroke patient's overall function. Neuromuscular exercises can improve activities of daily living (ADL) through coordination and balance activities. Traditional Chinese exercises are used to improve walking and balance ability as well as increase muscle strength, which is important for post-stroke patients.The present evidence strongly supports the power of exercise for post-stroke patients, which in this study combined aerobic exercises, strength training, flexibility exercises, neuromuscular exercises, and traditional Chinese exercises. This research can encourage post-stroke survivors to consider the importance of exercise in the rehabilitation process.

Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial

“…Exercise therapy and manipulation therapy can inhibit and weaken spasticity-inducing factors in patients with post-stroke limb spasm, so that limb movement control and motor function can be significantly strengthened and improved. However, a longer intervening time should be guaranteed in the treatment of post-stroke limb spasticity, and the individual condition of the patients should be taken into account in clinical practice [10,11]. In order to reduce the adverse effects caused by excessive exercise, we should adjust the range, intensity, frequency, and course of training.…”

Exercise Training Enhances Platelet Mitochondrial Bioenergetics in Stroke Patients: A Randomized Controlled Trial

“…In comparison with healthy individuals of the same age, reduced exercise capacity in stroke patients, especially about one month after onset of stroke, decreased their ability to perform daily activity independently, thereby further worsening their QoL [4,5]. The ventilatory parameters obtained from the GET may convey information regarding prognosis of circulatory disorders [23].…”

“…This limitation further decreases their independence and quality of life [1,2]. Although a randomized clinical study for 61 chronic stroke patients showed exercise training (ET) improved cardiovascular fitness [3] and a scientific overview encouraged post-stroke survivors to consider the importance of ET in regaining activities of daily living [4], controversy persists regarding how ET influences the hemostasis in stroke patients or stroke prevention [1,5].…”

Perspectives on the prospective development of stroke-specific lower extremity wearable monitoring technology: a qualitative focus group study with physical therapists and individuals with stroke

“…Individuals with stroke commonly face mobility limitations, beginning at stroke onset [1] and continuing past discharge into the community [2], and demonstrate a range of gait deviations due to altered motor control and resulting compensatory movement patterns [3]. Improving walking quality and quantity is a major focus of therapy [4], as doing so can improve mobility, fitness, quality of life, and prevent secondary complications [5,6]. One avenue to target walking for individuals with stroke may be to utilize wearable monitoring technology, as previous research has shown that application of an activity monitor can improve user self-efficacy and physical activity levels in various patient populations including older adults, breast cancer survivors, and those with chronic obstructive pulmonary disease [7][8][9][10][11].…”