Blog | Friday, May 30, 2014

QD: News Every Day--Prevention of secondary stroke also important during recovery

Low- to moderate-intensity aerobic activity, muscle-strengthening activity, reduction of sedentary behavior, and risk management for secondary prevention should be incorporated into the management of stroke survivors, a recommendation by the American Heart Association reads.

After stroke, 30% of survivors will have another one within their lifetimes, 18% of which will be fatal. “After stroke, health care professionals and stroke survivors tend to focus most of their rehabilitation on recovery, but the prevention of a subsequent stroke, as well as CAD and peripheral artery disease, is also an important task,” the authors wrote.

The scientific statement appeared online at Stroke.

Hospitalization and early convalescence should consist of low-level walking, self-care activities, intermittent sitting or standing, seated activities, or range of motion activities and motor challenges, the statement reads. The goal is to achieve increases in the resting heart rate of 10- to 20-beats per minute, using an interval or work-rest approach.

Inpatient and outpatient exercise therapy for aerobic improvement should target large-muscle activities such as walking, graded walking, stationary cycle ergometry, arm ergometry, arm-leg ergometry, or functional activities seated exercises. These can be done 3 to 5 days a week, in 20- to 60-minute sessions, or in multiple 10-minute sessions.

Inpatient and outpatient exercise therapy for muscular strength/endurance can include resistance training of the arms and legs, the trunk using free weights, weight-bearing or partial weight-bearing activities, elastic bands, spring coils, pulleys, circuit training and functional mobility. This can include 1 to 3 sets of 10 to 15 repetitions of 8 to 10 exercises involving the major muscle groups at 50% to 80% of 1 repetition maximum, for 2 to 3 days a week, with resistance gradually increased over time.

Flexibility exercises can include stretching of the trunk and extremities, using static stretches, holding for 10 to 30 seconds for 2 to 3 days a week.

Neuromuscular exercises can include balance and coordination activities, tai chi, yoga, paddles and balls to challenge hand-eye coordination, or computer games, 2 to 3 days a week.