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Exercise as it relates to Disease/Exercise for reducing the risk of stroke
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thumb|Hemorrhagic stroke
Background - What is a stroke?
A stroke is a brain attack which blocks blood flow to the brain, and deprives the brain tissue of vital oxygen and nutrients.National STROKE Association. (2013). <http://www.stroke.org/site/DocServer/STROKE_101_Fact_Sheet.pdf?docID=4541> [Accessed: 29/09/14]. When brain tissue is starved of this blood supply, brain cells begin to die at a rapid rate of two million brain cells a minute. Every moment that a patient is left untreated during a stroke increases the risk and severity of permanent brain damage, disability and death.Mayo Clinic Staff. Mayo Clinic. (2014). <http://www.mayoclinic.org/diseases-conditions/stroke/basics/definition/con-20042884> [Accessed: 29/09/14].
What are the different types of stroke?
Ischemic stroke – This is the most common type of stroke accounting for 87% of strokes suffered. An Ischemic stroke occurs when a blood clot or fatty deposit (i.e. plaque, atheroma) block the arteries.Heart Foundation. (2014). <http://www.heartfoundation.org.au> [Accessed: 29/09/14].
Hemorrhagic stroke – This is only responsible for 13% of all strokes, however, is more fatal accounting for 30% of all stroke deaths. A Hemorrhagic stroke occurs when a blood vessel in the brain bursts and leaks blood into the brain. This is typically as result of high blood pressure and/or diseases involving the blood vessels in your brain.
Transient ischemic attacks [TIA] – these are also known as ‘mini strokes’. These are a major precursor for strokes as 40% who suffer a TIA will go on to have a stroke. As you age, risk of suffering a TIA increases.
What are some risk factors for stroke?
Medical risk factors Lifestyle risk factorsShinton, R. Lifelong exposures and the potential for stroke prevention: the contribution of cigarette smoking, exercise, and body fat. Epidemiology and community health. 1997; 51:138-143. Suffered a stroke before Smoking Suffered a TIA before Being overweight High cholesterol Excess alcohol consumption High blood pressure High sodium diet Heart disease Arterial fibrillationGordan, N.F., Gulanick, M., et al. Physical activity and Exercise Recommendations for Stroke Survivors. American Heart Association. 2004; 35:1232-1234 Carotid artery disease
Strokes are not biased to age, sex, or race, and so everyone has a stroke risk. Some factors do increase an individual’s risk. Those over 55 years of age have an increased risk. Men when they are younger have a greater risk than women, but as women age they are more at risk, especially to fatality as result of stroke. African Americans have an increased stroke risk as do diabetics and those with a family history of stroke. But no matter the number of risk factors someone has, everyone should do what they can to minimise their risk.
What benefits will I see from exercise?
Up to 80% of all strokes are avoidable. This is because most strokes occur as result of unhealthy lifestyle choices.
Exercise will increase your Exercise will decrease your Chance of recovery Blood sugar levels General health Blood cholesterol levels Aerobic capacity Blood pressure Quality of life Body weight (when accompanied by healthy eating) Coronary artery endothelial function Risk of Heart disease
Recommendations for Exercise
Simply by meeting the daily recommended physical activity guidelines, stroke risk can be dramatically decreased.Australian Government Department of Health. (2014). <http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines> [Accessed: 29/09/14]. More specific exercise programs can be prescribed to cater for individual medications, disabilities, requirements and so forth.
Exercise Type Benefits How much Vigorous aerobic exercise
Improve peak oxygen uptake
Improve workload
lower blood pressure, and blood sugar
improve sensorimotor function
improve aerobic capacity
3 times per week Treadmill aerobic exerciseMacko, R.F., Desouza, C.A., et al. Treadmill Aerobic Exercise Training Reduces the Energy Expenditure and Cardiovascular Demands of Hemiparetic Gait in Chronic Stroke Patients. American Heart Association. 1997. 28: 326-330
reduces submaximal energy expenditure
improved cardiovascular fitness
daily living tasks done at lower percentage of aerobic capacity
lower blood pressure, and blood sugar
lower cholesterol
An a hour a day Combined cardiovascular, strength, and flexibility training
gains in peak oxygen uptake
gains in strength
improvements in body composition
lower blood pressure, and blood sugar
lower cholesterol
An hour a day 3 times per week High intensity interval training [HIIT] and Vigorous exerciseDr. Mercola. Peak Fitness. (2013). < http://fitness.mercola.com/sites/fitness/archive/2013/10/04/stroke-prevention-vigorous-exercise.aspx> [Accessed: 29/09/14].
reduces stroke risk for men and helps them recover faster
3 times per week
Exercise not only lowers the risk factors of having a stroke, it also minimises the disability of someone who has had a stroke and improves their quality of life. Exercise in a stroke survivor prevents complications of prolonged inactivity, decreases risk of recurrent stroke and cardiovascular events, increases aerobic fitness and enhances psychological functioning including concentration, memory and so on.
Guidelines you should know before getting started
If you are on and medications to lower blood pressure, cholesterol or any other health risks it is crucial that you see your doctor before participating in any exercise. Any healthcare professional leading you through an exercise program should also complete an Adult Pre-exercise Screening System [APSS]to ensure you are cleared to participate safely.ESSA. (2014). <https://www.essa.org.au/for-gps/adult-pre-exercise-screening-system/> [Accessed: 29/09/14].
Further information/ suggested reading / support groups
Physical activity and exercise recommendations for stroke survivors. Exercise recommendations for stroke survivors
Support groups Stroke support groups- Australia
Treadmill aerobic exercise for stroke survivors. AHA guidelines
Lifestyle risk factors for stroke. Effect on stroke risk
Reduce your stroke risk:Health tip
References