Intervention
Physical fitness training describes a systematic, progressive increase in the intensity or resistance, frequency, or duration of the physical activity throughout a scheduled program.
Training may involve cardiorespiratory or resistance training or a mixture of cardiorespiratory and resistance training. There is little evidence to support resistance training on its own.
Physical fitness training can also help manage stroke comorbid conditions and risk factors (blood pressure, diabetes, obesity, depression).
Indication
Physical fitness is often reduced in patients following a stroke and may limit their ability to perform everyday activities and also worsen any stroke-related disability.
People who are ambulatory following a stroke with the aim of reducing the risk of disability via improved mobility and balance.
Most stroke survivors are able to participate in a variety of short-term fitness training regimens, either during usual stroke care or after hospital discharge. Benefits have been shown with training commencing more than seven years after stroke.
Physical fitness training can also help manage stroke comorbid conditions and risk factors (blood pressure, diabetes, obesity, depression).
Precautions
Risks of physical fitness training for patients following a stroke include soft tissue injuries and falls.
Adverse effects
Participation in fitness training programs appears to be safe and does not result in serious adverse events.
Availability
Several of the studies in the review featured supervised walking. Many organisations such as Stroke Foundation, Heart Foundation, gyms and community centres have local walking groups (or links to walking groups). See Consumer resources.
Description
Cardiorespiratory training
Types of training include walking (most commonly evaluated), ergometry (eg cycle ergometer, which is a stationary exercise bike with an ergometer that measures the exercise effort; treadmill walking; an arm ergometer), circuit training and aquatic exercise. Patients train 2–6 days per week, with each session lasting at least 20 minutes. Evaluated programs vary in duration from 2 to 24 weeks.
Mixed training (cardiorespiratory and resistance training)
Exercises include circuit training or various combinations of walking, treadmill training and resistance training. In evaluated interventions, patients trained 2–7 days per week, with each session lasting 30–120 minutes, for up to about 12 weeks.
Tips and challenges
Physical fitness training may reduce post-stroke fatigue. However, this fatigue can act as an initial barrier to starting exercise.
Grading
NHMRC Level 1 evidence.