Exercise for stroke prevention

Abstract

We review evidence concerning exercise for stroke prevention. Plausible biological reasons suggest that exercise would be important in preventing stroke. While definitive randomised controlled trials evaluating the impact of physical activity (PA) and exercise on preventing stroke and mortality are lacking, observational studies, small randomised controlled trials and meta-analyses have provided evidence that PA and exercise favourably modify stroke risk factors, including hypertension, dyslipidaemia, diabetes, sedentary lifestyle, obesity, excessive alcohol consumption and tobacco use. It is, therefore, important to understand the factors associated with poststroke PA/exercise and cardiorespiratory fitness. Positively associated factors include self-efficacy, social support and quality of patients’ relationships with health professionals. Negatively associated factors include logistical barriers, medical comorbidities, stroke-related deficits, negative exercise beliefs, fear of falling, poststroke fatigue, arthropathy/pain and depression. Definitive research is needed to specify efficacious behavioural approaches to increase poststroke exercise. Effective techniques probably include physician endorsement of exercise programmesto patients, enhancement of patient–professional relationships, providing patients an exercise rationale, motivational interviewing, collaborative goal-setting with patients, addressing logistical concerns, social support in programsmes, structured exercise programming, individualised behavioural instruction, behavioural diary recording, reviewing behavioural consequences of exercise efforts, reinforcing successful exercise performance. Exercise programming without counselling may increase short-term activity; simple advice or information-giving is probably ineffective. Older patients or those with cognitive impairment may need increased structure, with emphasis on behaviour per se, versus self-regulation skills. We support the latest American Heart Association/American Stroke Association guidelines (2014) recommending PA and exercise for stroke prevention, and referral to behaviourally oriented programmes to improve PA and exercise.

Effectiveness of Motivational Interviewing in Regard to Activities of Daily Living and Motivation for Rehabilitation among Stroke Patients

“…Third, the first stroke might have had some psychological impact. Post-stroke depression can affect the motivation for rehabilitation and the performance of activities of daily living [4,10]. It has been shown that approximately one-third of stroke survivors were influenced by post-stroke depression after their first stroke [4,11].…”

“…Motivational interviewing (MI) is defined as a patient-centered, non-confronting communication method that applies five important principles of consultation, including rolling with resistance, expressing empathy, avoiding argumentation, developing discrepancy, and supporting self-efficacy, which is abbreviated as READS [9]. MI could improve the survival rate, medication compliance, and knowledge of stroke patients, change their lifestyle, and enhance their intrinsic motivation [10]. Currently, there is insufficient evidence of whether the MI intervention in first-stroke patients could influence their activities of daily living and rehabilitation motivation.…”

Exercise Training as Part of Musculoskeletal Management for Congenital Myopathy: Where Are We Now?

“…They not only improve cardiovascular capacity but also reduce the risk of many conditions related to the sedentary lifestyle, including obesity, type 2 diabetes, metabolic syndrome, and stroke among others. [41][42][43] It has also been shown that aerobic exercises improve muscle strength and tone in the larger muscle groups 44 and bone density when weight bearing is involved. 45 These effects potentially could be highly beneficial for patients with CM.…”

Paroxysmal supraventricular tachycardia and risk of ischemic stroke: A systematic review and meta‐analysis

“…Approximately 90% of stroke patients had ischemic stroke. There are several well‐recognized risk factors for ischemic stroke, such as age, male sex, hypertension, diabetes mellitus, smoking, hypercoagulable state, and atrial fibrillation …”

“…ischemic stroke, such as age, male sex, hypertension, diabetes mellitus, smoking, hypercoagulable state, and atrial fibrillation. 8,9 Interestingly, recent literatures have suggested that PSVT may also be a risk factor for ischemic stroke similar to atrial fibrillation (although at a smaller magnitude). [10][11][12][13][14][15] Nonetheless, the data were still relatively limited and inconclusive.…”