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AHA Scientific Statement: Physical Activity and Exercise Recommendations for Stroke Survivors1 - page 3

As is the case for the general population, the major potential health hazards of exercise for stroke survivors are likely to include muscle injury and sudden cardiac death. Depending on the severity of disability and other coexisting medical conditions, certain patients may need to participate in a medically supervised exercise program. However, before embarking on a physical conditioning regimen, it is recommended that all stroke survivors undergo a complete medical history and a physical examination, aimed at the identification of neurological complications and other medical conditions that require special consideration or add up to a contraindication to exercise.

Recommendations for Exercise Programming

Prescribing exercise for the stroke patient is comparable in many ways to prescribing medications; that is, one recommends an optimal dosage according to individual needs and limitations. Aerobic training modes may include leg, arm, or combined arm-leg exercise at 40% to 70% of one's peak heart rate reserve, with a patient's perceived exertion used as an additional method of targeting the optimal intensity of exercise. The recommended frequency of training is 3 to 7 days a week, with a duration of 20 to 60 min/day of continuous or accumulated exercise (eg, 10-minute bouts), depending on one's level of fitness. Intermittent training protocols may also be needed during the initial weeks of rehabilitation because of the extremely de-conditioned level of many convalescing stroke patients.

To maximize conditioning of a patient's ability to perform daily activities, additional upper-body and strength-training programs (example: lifting dumbbells or pulling on rubberized resistance bands) are also recommended for clinically stable stroke patients. Such regimens should be performed 2 to 3 days per week and include a minimum of 1 set of at least 8 to 10 exercises that involve the major muscle groups (arms, shoulders, chest, abdomen, back, hips, and legs).

Safety First: Before you start any exercise program get an O.K. from your doctor followed by guidance from appropriate allied health professional !!

"Physical activity remains a cornerstone in the current store of risk-reduction therapies for the prevention and treatment of stroke. Exercise is a cost-effective intervention, which is now strongly supported by sound research and holds tremendous promise. The challenge for healthcare providers is to bring this promise to fruition." http://circ.ahajournals.org/cgi/content/full/109/16/2031?eaf - R19-146617#R19-146617

Murray Low Ed.D., FACSM, FAACVPR.
Cardiac Rehabilitation Program Director at various rehabilitation centers in the Bronx, Westchester and lower CT area.