We all know how important exercise is for our health. But actually walking the walk can be difficult. This can’t be truer for stroke survivors. When you’re living with limited function, it’s hard to get out there and exercise. Unfortunately, stroke survivors are probably the ones who need regular exercise the most. How should survivors be training for stroke recovery?
How can we help stroke patients get moving? To help people manage with their disabilities, we can use something called forced exercise. It’s not as awful as it sounds. Basically, forced exercise is when you exercise with the help of a machine or motor. For example, you could be biking with a motor helping you pedal faster than what you could do on your own.
It’s just like the new European fad, e-bikes. E-bikes are bikes fitted with electric motors to help you go faster and for a longer period of time without getting as tired. Essentially, you’re biking with a little help from a small engine. That way, you can go farther without using as much energy! You might be wondering what the difference is from a motorcycle. Well, it turns out that this nifty motor only helps you if you help yourself. What this means is that you need to pedal for it to work. It’s not going to do anything unless you’re doing it yourself too.
A story of how exercise helped one stroke patient get better
So we know that exercise is good for you, and that’s what worked for one African American stroke survivor. The 46-year-old did aerobic workouts paired with task-specific exercises. Because he had suffered a left-sided stroke almost a year ago, he had some problems with strength and coordination in his right arm and leg. He also had problems speaking and had issues with memory and brain function too. Even though he had multiple medical problems like high blood pressure, obesity, diabetes, and high cholesterol, he didn’t give up on himself. He was very motivated to get better. With supervision from his healthcare team, he did exercises 3 times a week for 8 weeks. These training sessions consisted of 45 minutes of cycling. He would start with a 5-minute warm-up, a 35-minute exercise period, and a 5-minute cooldown.
Because intensity is so important when exercising for your health, they needed to get him to an optimal heart rate for moderate exercise. For him, it was a goal of 105 to 120 heart beats per minute. At first, he would already be reaching this level with only 70 rotations per minute on the bike. Then, as he got stronger, he was eventually up to 80 rotations per minute by session 12. He maintained this new endurance throughout the rest of his training sessions during those 8 weeks.
How combined therapy did wonders for this patient
So he had the work out down, but what about his task-specific therapies? Whenever he was cycling, he was engaging in therapy too. 15 minutes after his cycling workout, he would participate in a 45-minute session of upper arm therapy doing repetitive task practice with an occupational or physical therapist. Usually, this would involve performing 3-4 specific tasks repeatedly that focus on improving his movements of that arm. He would do these tasks about a 100 times each per session.
There was good news at the end of this combination of training with aerobic exercise. After eight weeks of combined aerobic exercise and focused repetitive task practice, the patient improved in all of his motor outcomes. He even improved in other aspects of his abilities and health that had nothing to do with motor function! He was able to maintain heart rate above his target for almost half of his training sessions too. This is definitely not common for someone who has medical problems like him.
The science behind why exercise is good for stroke recovery
So why did exercise help this man? Scientists have found that your brain and spinal cord benefit from physical activity because of a hormone called Brain-Derived Neurotrophic Factor, or BDNF. This little molecule rises in your brain and spinal cord when you are physically active. Researchers have been excited to find that BDNF could potentially help with regaining motor functions after stroke. By exercising and releasing this hormone, your body can do a better job repairing neurons. If you exercise while going through repetitive motion therapies, you can help your body improve functions you are trying to recover in rehab.
It’s time to get moving!
If you’ve suffered a stroke, it’s time to start exercising. The hardest part is getting started because it can be intimidating to work out when you’re suffering from new disabilities. But don’t give up! As we can see from this case study, exercise can really benefit you in your overall stroke recovery. The more you can do, the better your quality of life! It’s free to exercise and can help you manage your mental and physical health altogether. The American Heart Association recommends around 40 minutes of aerobic exercise regularly. Talk with your doctor and therapist to see what aerobic workouts are best for you or check out our Strokemark app to get you started!
The first author of this study was Dr. Susan M. Linder, the Department of Biomedical Engineering at Cleveland Clinic, Cleveland, Ohio.