While regular exercise has many health benefits, a new study found that stroke survivors who completed a cardiac rehab program with an emphasis on aerobic exercise significantly improved their ability to move from sitting to standing and how far they walk during a six-minute walk test can.
The research was published today in the Journal of the American Heart Association, an open access journal of the American Heart Association.
Cardiac rehabilitation is a structured exercise program that is popular in the United States for people with cardiovascular disease and has been shown to increase cardiovascular endurance and improve quality of life. Despite many similar cardiovascular risk factors, stroke is not a covered diagnosis for cardiac rehabilitation.
Physical inactivity is common among stroke survivors. More than 75 percent of all US stroke survivors do not get the guideline-recommended amount of exercise (150 minutes of moderate-intensity physical activity or 75 minutes of high-intensity physical activity per week). . Currently, exercise-based cardiac rehabilitation programs are not the standard for caring for stroke survivors in the United States
“Through this study, we hoped to improve manageable risk factors for stroke survivors and potentially prevent future stroke and cardiac events,” said lead study author Elizabeth W. Regan, DPT, Ph.D., clinical assistant professor of exercise science in the physiotherapy program at the University of South Carolina in Columbia, South Carolina.
“Increasing physical activity is an important way to prevent stroke, and we wanted to see if the rehab patients received after a heart attack could have similar positive outcomes for patients who survived a stroke,” added Regan .
Researchers started a pilot study at a North Carolina medical center to investigate the benefits of a cardiac rehabilitation program for stroke survivors. A total of 24 participants, ages 33 to 81, who had had a stroke three months to ten years earlier, took part in a cardiac rehab program that included 30 to 51 minutes of aerobic exercise three times a week for three months.
At the beginning of the program, participants were assessed for their physical function (cardiovascular endurance, functional strength, and walking speed) and other health measures such as a mental health questionnaire and a balance test. In a post-program evaluation, participants repeated these evaluations. At a six-month follow-up appointment, they completed the same tests one last time and answered questionnaires about lifestyle and exercise habits. At the initial evaluation after the program, the researchers found that compared to when the study started:
Participants saw an improvement in the distance they could walk during a six minute walk. On average, each participant improved their distance by 203 feet.
Participants improved their ability to quickly switch from sitting to standing in the five sit-stand test. Improvements in this test correspond to increased leg strength and may correspond to a lower risk of falls for people who have had a stroke.
Study participants improved their Task Level Metabolic Equivalent (MET), or the maximum amount of energy the average person produces to complete a given task, by approximately 3.6. For example, one metabolic equivalent of the task is defined as the energy needed to watch TV and seven are needed to jog. At the six-month follow-up, participants had maintained these increases, and 83.3% of participants said they were still exercising at least once a week.
“Our primary goal as healthcare professionals is to help stroke survivors reduce as many risk factors as possible in order to prevent future stroke or cardiovascular disease. Based on these preliminary findings, we hope that prescribing cardiac rehabilitation for All post-stroke patients will be considered as it is for post-heart attack patients, “Regan said.
“We need to place emphasis on exercise as a medicine. Exercise is health and is important for everyone, regardless of their physical limitations or age. Hopefully, increasing physical activity can be one of the first steps in improving overall health after a stroke,” Regan added added.
This study included a small patient sample and was a pilot study at a single center in a multi-center healthcare system. Therefore, larger studies are needed to confirm these preliminary results.
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