Our last ‘Ask an Expert’ opportunity, a feature of the StrokeConnect Online forum, invited questions about exercise after stroke. Associate Professor Julie Bernhardt, National Stroke Foundation Clinical Council member and specialist in rehabilitation, answered questions on exercise after stroke.
Questions ranged from how to exercise in hospital to how to stave off fatigue. Here is an edited version of the conversation. For the full transcript of Julie’s answers and members’ questions just go to StrokeConnect Online www.strokefoundation.com.au
When the best of my energy goes into my work, how can I exercise to adequate levels?
This is always a tricky issue and not just for people affected by stroke. I would suggest you find a time when you naturally feel energised: morning, lunch time, weekend and start to integrate exercise into your week. Do something that you enjoy – even walking outdoors for a short time and building up to a longer spell would be good.
Why is exercise recommended after stroke to reduce fatigue?
Fatigue is ranked as the sixth top research priority for people affected by stroke according to a recent UK study www.lindalliance.org and it is one of the major problems influencing quality of life after stroke. Right now we don’t really understand enough about what causes fatigue but in recent years researchers are turning their attention to the topic. ‘Brain’ fatigue is probably different to ‘body’ fatigue and fatigue is also related to depression, which is common after stroke. We have no clear evidence that exercise improves fatigue after stroke, but in other areas like chronic fatigue and multiple sclerosis, we know that exercise helps the experience of fatigue.
How essential is daily exercising for 30 minutes?
That prescription is a general healthy habit and one we should all aim for. You can also accumulate your exercise in shorter, more intensive bursts.
How hard does my body have to be working for an activity to be considered exercise?
If you have had a stroke you probably use up more energy doing simple activity than someone who hasn’t had a stroke. If you feel that you have an elevated heart rate and that you are ‘working’ then without any other way of measuring it I would call that exercise. If you want to track it, consider buying yourself an activity monitor to track your activity.
What exercises can I be doing seated or standing if I have poor balance?
You can still do strengthening exercises with weights while seated or lying that can help your fitness if you want to do these at home or in a gym. The National Stroke Foundation has partnered with the Heart Foundation to adapt their Heartmoves exercise program for stroke survivors. You can find out more about Heartmoves for Stroke online at www.heartfoundation.org.au/heartmoves or call 1300 362 787.
What exercise can I be doing in hospital?
Regular walking is probably a good one. The usual problem in hospital is that staff are busy and you don’t want to ask them! If you need help a family member or friend may be able to come with you.
The next Ask an Expert forum topic is ‘fever & swallowing management in stroke care’ with Professor Sandy Middleton. Click on to the StrokeConnect Online forum to be involved and if you haven’t already done so, register – it’s quick and it’s free.