Poststroke exercise – the benefits

This review aimed to describe the benefits of physical activity and cognitive training for stroke patients. The authors concluded that aerobic exercise combined with resistance exercise was more beneficial than either alone.

Stroke patients commonly experience motor or cognitive disabilities that can affect their ability to live independently. These disabilities include impaired and slower walking due to muscle weakness and reduced physical fitness as well as poorer attention, memory and language abilities.  Recommendations for stroke patients includes physical and cognitive training, however there is much that has not been fully described. More study needs to be done to determine the extent of the benefits from physical and cognitive training, the optimal timing and type of training and the ability of the patient to tolerate increased physical activity.

This review focuses on the benefits of both exercise and cognitive training for stroke patients.

Primarily, increased physical activity had several benefits for stroke patients including weight control, reduced risk of diabetes, cardiovascular disease, arthritis, osteoporosis, cancer and depression.

The authors identified two types of exercise used in post-stroke training; aerobic exercise (AE) to improve cardiovascular fitness and resistance exercise (RE) to improve muscle strength.

For AE, a stationary bike was more beneficial than a treadmill. In patients who took part in AE for 20-40 minutes per day, 3-5 days per week, benefits were seen after 8-12 weeks. There were no adverse effects associated with AE. One study reported a 6% rate of stroke recurrence with AE, but this rate was the same as the general population.

RE is understudied with limited data, however improved muscle strength leads to better weight bearing and gait speed. One study found the benefits of RE lasted even 7 years following the end of the study. There were also no adverse effects associated with RE.

CARET refers to a combination of AE and RE training. CARET was more beneficial to strength, endurance and balance and is potentially linked with improved cognitive performance.

Combining cognitive training with exercise showed improved post-stroke fatigue. The authors stated however that the evidence of a benefit of cognitive training on specific brain impairments is limited. Studies have small sample sizes with inconclusive results.

The authors concluded that a combination of aerobic and resistance exercise is more beneficial than either alone, but they note that evidence for this is limited. They state that more studies need to be done to determine the extent of benefits of physical activity and cognitive training.