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RECOMMENDED GUIDELINES FOR POST-STROKE EXERCISE

In May of 2014 the American Heart Association and American Stroke Association published recommended that physicians prescribe exercise to stroke survivors. This chart outlines their recommendations.


Exercise Therapy Mode

Goals/Objectives

FIT Guidelines

AEROBIC ACTIVITY:

Stationary bike, arm ergometer, arm-leg ergometer, functional activities, seated exercises if appropriate

Increase walking speed and efficiency, improve exercise tolerance, independence in activities of daily living (ADLs), reduce motor impairment

• 40-70% of HHR, 55-65% HRmax, RPE 11-14 (6-20 scale)

• 3-5 days per week

• 20-60 min per session

• 5-10 min warm-up

• Complement with pedometers to increase lifestyle physical activity

MUSCULAR STRENGTH AND ENDURANCE:

Resistance training of upper and lower extremities using free weights, weight-bearing or partial weight-bearing activities, elastic bands, spring coils, pulleys
• Circuit training
• Functional mobility

• Increase muscle strength and endurance, ability to perform leisure-time and occupational activities and ADLs
• Reduce cardiac demands during lifting or carrying objects


• 1-3 sets of 10-15 reps of 8-10 exercises at 50-80% of 1RM

• 2-3 days per week

• Resistance gradually increased over time

FLEXIBILITY:

Stretching

• Increase ROM of involved areas
Prevent contractures
• Decrease risk of injury
• Increase ADLs

Static holding for 10-30 secs

2-3 days per week before or after aerobic or strength training

NEUROMUSCULAR:

Balance and coordination activities
• Tai chi
• Yoga
• Recreational activities using paddles/sport balls to challenge hand-eye coordination
• Active play video gaming and interactive computer games


• Improve balance, skill reacquisition, quality of life, mobility
Decrease fear of falling
• Improve level of safety during ADLs

Use as a complement to aerobic, muscular strength/endurance, and stretching activities

2-3 days per week