Exercise Rehabilitation After Stroke

Stroke is a leading cause of disability that results not only in persistent neurological deficits, but also profound physical deconditioning that propagates disability and worsens cardiovascular risk. The potential for exercise-mediated adaptations to improve function, fitness, and cardiovascular he...

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Bibliographic Details
Published in:NeuroRx 2006-10, Vol.3 (4), p.439-450
Main Authors: Ivey, Frederick M., Hafer-Macko, Charlene E., Macko, Richard F.
Format: Article
Language:English
Subjects:
Adaptation, Physiological
Animals
Body Composition - physiology
chronic disability
Exercise
Exercise Therapy
Gait
Humans
Motor Skills
Physical Fitness
rehabilitation
Risk Factors
Stroke
Stroke - metabolism
Stroke Rehabilitation
treadmill
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Summary:Stroke is a leading cause of disability that results not only in persistent neurological deficits, but also profound physical deconditioning that propagates disability and worsens cardiovascular risk. The potential for exercise-mediated adaptations to improve function, fitness, and cardiovascular health after stroke has been underestimated: it represents an emerging arena in neurotherapeutics. To define the health rationale for cardiovascular (aerobic) exercise, we first outline the impact of debilitating secondary biological changes in muscle and body composition on fitness and metabolic health after stroke. We provide an overview of evidence-based advances in exercise therapeutics, with a focus on task-oriented models that combine a progressive aerobic conditioning stimulus with motor learning to improve multiple physiological domains that determine longitudinal outcomes after stroke. Although progress in development of safe and effective exercise strategies is advancing, fundamental questions regarding dose intensity, prescription to optimize central and peripheral neuromuscular adaptations, and the public health value of exercise in secondary stroke prevention remain unanswered. Key issues steering future research in exercise neurotherapeutics are discussed within the context of initiatives to facilitate translation to community-based studies, requisite for dissemination.
ISSN:1545-5343
1933-7213
1545-5351
1878-7479
DOI:10.1016/j.nurx.2006.07.011