Benefits of Exercise for Stroke Patients

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Did you know one in four people globally will have a stroke in their lifetime, with one Australian having a stroke every 19 minutes?i That means over 530 people in Australia experience a stroke every week. If you or someone you love has had a stroke, you’ll know exercise is a vital part of rehabilitation.

Importantly, the benefits of exercise for stroke patients continue long after the early stages of recovery. A stroke can lead to difficulties with various aspects of your physical function, such as your balance, walking, co-ordination, and ability to use your arm and hand. Exercise can help with these functions, leading to enhanced independence. It can also assist with your overall health and ability to participate in activities you enjoy, leading to a better quality of life. In fact, if you’ve had a stroke, exercise should become part of your everyday lifestyle.

Despite the known benefits of exercise for stroke patients, many don’t get enough of it. We discuss the benefits of exercise for stroke recovery and provide some tips for making exercise part of your routine.

Why is exercise important for stroke patients?

Exercise has proven physical health benefits for all people, including reducing your risk of developing type 2 diabetes, high blood pressure, and of having a stroke in the first place. It also has known mental health benefits, as exercise triggers the release of chemicals that boost mood and help to ease depression and anxiety symptoms.

If you’ve had a stroke, the chances are high that you will experience some ongoing effects in movement and sensation. These include muscle weakness and/or rigidity, reduced co-ordination, decreased sensation in affected body parts, and decreased awareness of where your body is in relation to your environment. Additionally, many stroke survivors experience difficulties with fatigue, pain, vision, cognitive function, and mood.

These can adversely impact your ability to work, move around independently and safely, participate in sport or hobbies, and perform everyday tasks such as dressing, showering and toileting. To complicate matters, you may experience feelings of loss, frustration, worry, and lack of motivation.

The good news is that exercise can assist with nearly all these issues.

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Exercise for stroke patients can improve recovery, function, and quality of life

Importantly, the benefits of exercise for stroke patients have been proven by research. A systematic review published in 2020iiexamined results from 75 studies looking at the effects of cardiorespiratory exercise, resistance exercise or mixed training interventions for people who’ve had a stroke. The researchers found these interventions led to multiple benefits. Explaining what their findings mean, the authors note that:

  • Cardiorespiratory (aerobic) training on its own can improve fitness – with benefits for functional capacity and the potential to reduce the risk of secondary health events.
  • When exercise involves walking training, either as cardiorespiratory training alone or in combination with resistance training, it improves walking speed and capacity.
  • Cardiorespiratory training or resistance training on their own or in combination improve balance, which may reduce post-stroke falls risk.
Woman walking on a path between trees using walking poles.

Cardiorespiratory exercises like walking can improve your function and fitness after a stroke.

Vitally, no serious adverse events were reported. The authors concluded that cardiorespiratory training (and mixed training to a lesser extent), reduce disability during or after usual post-stroke care.

In another clinical review of the benefits of exercises for stroke patientsiii, the authors say the evidence clearly supports using various kinds of exercise training – such as aerobic, strength, flexibility, and neuromuscular exercise – for stroke survivors. As they point out: “This research can encourage post-stroke survivors to consider the importance of exercise in the rehabilitation process.”

While more research is needed, a recent studyivfound increased time spent walking was strongly related to lower levels of fatigue in stroke survivors.

Exercise is so well-recognised for its vital role in stroke recovery and post-stroke quality of life, it is recommended by groups including Australia’s Stroke Foundationv, the American Stroke Associationvi, and the United Kingdom’s Stroke Associationvii.

Stroke survivors often don’t get enough exercise

Despite the proven benefits of exercise for stroke patients, research also shows that many stroke survivors don’t get enough physical activity. A 2017 studyviii examining how physically active people are following a stroke looked at results from 103 papers including 5306 participants aged 21 to 96 years. They found people who’d had a stroke took an average of 5535 steps per day, compared to 8338 in matched healthy individuals. They also found the average sedentary time for stroke survivors was very high, at more than 78%.

Similarly, a 2013 analysis of 11 studiesix found that physical activity levels were generally low in quantity, duration and intensity in stroke patients. The authors noted poorer walking ability, specific difficulties with sensory or motor function, and low mood were correlated with low physical activity levels.

This highlights how a range of factors can impact your ability to exercise after a stroke, such as paralysis or weakness down one side of your body, difficulties with speech, poor co-ordination, lack of fitness, fear of injury, and lack of access to appropriate exercise facilities. This makes finding a type of exercise suited to your needs, goals, and functional capacity especially important for stroke survivors.

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The benefits of exercise for stroke patients :

As noted above, exercise has a wide range of benefits for people who’ve had a stroke. These include improvements in:

Strength – resistance exercises using your body weight, dumbbells, resistance bands or machines improves muscular strength and endurance. Stronger muscles can improve your ability to perform everyday tasks like walking, climbing stairs, getting on and off the toilet, lifting things and opening jars. Better strength in your legs and core may also reduce your risk of having a fall.

Joint mobility – exercise designed to stretch tight muscles and improve joint flexibility can increase the range of motion available in your joints. This may assist with pain and help you more easily perform activities like getting in and out of a car, getting down and up off the floor, dressing yourself, pegging clothes on the line and reaching into high cupboards.

Balance – exercises that challenge your balance can improve your ability to hold your balance on the spot and deal with balance challenges in your environment, such as being jostled in a crowd or encountering rough patches on the footpath.

Coordination – specific exercises designed to improve you coordination can help with many movements and activities, such as your ability to walk, roll over in bed, sit and stand from chairs, and dress, feed and shower yourself.

Older man with grey hair doing push up exercise beside the beach.

If you’ve had a stroke, exercise can boost your strength, mobility, coordination and more.

Swelling – after stroke, some people experience a fluid build-up (known as oedema) in their affected arm or leg. Movement activates the lymphatic system, which shifts fluid and can therefore reduce swelling.

Fatigue – although it may seem counterintuitive, the right amount and type of exercise can actually reduce neurological fatigue and boost your energy levels after stroke.

Pain – by improving flexibility in your muscles and joints, and by rewiring nervous system pathways, exercise may assist with pain management.

Brain health – exercise triggers the release of chemicals that support the maintenance of healthy brain tissue and neurological function.

Significantly, regular exercise can help to reduce your chances of having another stroke. In one study of stroke survivorsx, physical inactivity was the strongest single predictor of a stroke recurrence.

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Tips on exercises for stroke patients

In a 2021 paperxi, a group of experts emphasise that physical activity must be part of effective stroke rehabilitation and secondary stroke prevention programs. But as we’ve noted, it can be difficult for stroke patients to get enough exercise. Here are some tips to help you or someone you support get more physical activity after a stroke.

 

  1. Find an activity you enjoy – to stick with an exercise routine, it’s imperative to find a type of exercise you enjoy. Depending on how your stroke has affected your function, you might need to use adaptive equipment such as a modified exercise bike, or receive assistance from a support person to get to an exercise facility or perform exercises safely at home.
  2. Start slowly – many exercise programs get abandoned because people try to do too much too soon. Start out slowly. Even a few minutes every day is better than nothing, and you can build up from there.
  3. Make exercise a habit – aim to incorporate exercise into your daily routine. For example, go for a walk after lunch, or do your exercise program first thing after brushing your teeth in the morning.
  4. Reward yourself – if you don’t naturally enjoy exercise, set up a system of rewards. For example, schedule time to do something fun or buy something you want if you meet your weekly exercise goals.
  5. Seek support – if you have concerns about getting started or finding the type of exercise that’s right for you, get professional support. Accredited exercise physiologists, like those at Active Ability, have university qualifications in prescribing exercise for people with medical conditions such as a stroke.

Our NDIS registered, mobile physiotherapists & exercise physiologists can see you at your home, workplace, gym, or other convenient location to help you work towards your goals. Once your physiotherapist has met with you for your initial assessment, they will be able to recommend whether you require physiotherapy, exercise physiology or a combination of the two so that you can begin on the road to achieving your goals!

With no travel charges or waiting lists, we can see people in Sydney, Wollongong and the Sunshine Coast in a timely manner that ensures the best use of your funding.

To find out more about how we might be able to help you or your loved one after a stroke, contact our friendly team on (02) 8355 1747, hello@activeability.com.au or via our contact form.

REFERENCES:

[i] – Stroke Foundation. Top 10 facts about stroke https://strokefoundation.org.au/about-stroke/learn/facts-and-figures. Accessed online 11.7.2022.

[ii] – Cochrane Library. Physical fitness training for stroke patients. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003316.pub7/full. Accessed online 11.7.2022.

[iii] – Advances in Experimental Medicine and Biology. Clinical Evidence of Exercise Benefits for Stroke. doi: 10.1007/978-981-10-4304-8_9. Accessed online 11.7.2022.

[iv] – Physiotherapy Research International. Fatigue and activity after stroke. Secondary results from the Life After Stroke study. https://doi.org/10.1002/pri.1851. Accessed online 11.7.2022.

[v] – Stroke Foundation. Mobility and exercise after stroke. https://strokefoundation.org.au/what-we-do/for-survivors-and-carers/stroke-resources-and-fact-sheets/mobility-and-exercise-after-stroke-fact-sheet. Accessed online 11.7.2022.

[vi] – Stroke. Physical Activity and Exercise Recommendations for Stroke Survivors. https://doi.org/10.1161/STR.0000000000000022. Accessed online 11.7.2022.

[vii] – Stroke Association. Getting active after a stroke. https://www.stroke.org.uk/resources/exercise-and-stroke. Accessed online 11.7.2022.

[viii] – Physical Therapy and Rehabilitation Journal. How Physically Active Are People Following Stroke? Systematic Review and Quantitative Synthesis. https://doi.org/10.1093/ptj/pzx038. Accessed online 11.7.2022.

[ix] – International Scholarly Research Notes. Physical Activity after Stroke: A Systematic Review and Meta-Analysis. https://doi.org/10.1155/2013/464176. Accessed online 11.7.2022.

[x] – Neurology. Relationship between risk factor control and vascular events in the SAMMPRIS trial. doi: 10.1212/WNL.0000000000003534. Accessed online 11.7.2022.

[xi] – Stroke. How to Address Physical Activity Participation After Stroke in Research and Clinical Practice. https://doi.org/10.1161/STROKEAHA.121.034557. Accessed on line 11.7.2022.