Groups call for more exercise after stroke

One of the key times for patients to stay active is when their stroke rehabilitation program is wrapping up, Billinger said. It can be intimidating, she said, to go from working one-on-one with a physical therapist to exercising in a gym, for instance.

“There’s a gap after rehabilitation in the U.S. specifically,” she told Reuters Health. “We haven’t quite bridged that as well as some of the other countries.”

The authors note that evidence is lacking on how to encourage activity among people who can’t walk after a stroke or who have trouble communicating.

Any guidance should be tailored to the needs of a particular patient, they add.

Rimmer agreed. “Exercise really needs to be as individualized as medication,” he said.

He told Reuters Health that recumbent steppers can be an option for people with more limited mobility, because they are easy to get on and off and are very safe.

More research is needed to help find the optimal dose of exercise to lower the risk of falls or second strokes, for instance, Rimmer said.

Coffee, exercise may raise stroke risk for some
Having sex, drinking coffee, working out - these and other everyday activities that cause blood pressure to spike may briefly raise the risk of a burst aneurysm in the brains of certain vulnerable people, a new study suggests.

Roughly 2% of the population is believed to have an aneurysm, a balloon-like swelling in a brain artery that results from a weak spot in the artery wall.

Aneurysms are usually too small to cause symptoms or problems, but if they grow large they can burst and cause a stroke, leading to permanent brain damage or death.

The overall risk of rupture is small. However, even brief activities that raise blood pressure can temporarily boost the risk, according to the study, which appears in the journal Stroke.

For instance, the risk appears to nearly double in the hour after drinking a cup of coffee, the researchers found.

“We investigated those factors that were known to cause a short-lasting sudden increase in blood pressure,” says the lead author of the study, Monique Vlak, M.D., a neurologist at the University Medical Center, in Utrecht, the Netherlands. “Other researchers have already described that sexual activity or physical exercise are often reported by patients to precede rupture, but these potential risk factors were never quantified.”

Groups call for more exercise after stRoke Billinger said patients should talk with their doctor before starting any intensive exercise. She emphasized that for people who are limited in their exercise capabilities, even walking back and forth to the mailbox a few times a day is a good start.

“Anything to get them moving is better than nothing,” she said.

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SOURCE: Stroke, online May 20, 2014

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Physical Activity and Exercise Recommendations for Stroke Survivors
A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

  Sandra A. Billinger, PT, PhD, FAHA, Chair,
  Ross Arena, PT, PhD, FAHA, Co-Chair,
  Julie Bernhardt, PT, PhD,
  Janice J. Eng, BSc, PT/OT, PhD,
  Barry A. Franklin, PhD, FAHA,
  Cheryl Mortag Johnson, OTR,
  Marilyn MacKay-Lyons, BSc, MScPT, PhD,
  Richard F. Macko, MD,
  Gillian E. Mead, MD, MA, FRCP,
  Elliot J. Roth, MD, FAHA,
  Marianne Shaughnessy, PhD, RN, CRNP and
  Ada Tang, PT, PhD;
  on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Lifestyle and Cardiometabolic Health, Council on Epidemiology and Prevention, and Council on Clinical Cardiology

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