Deconditioning after a Stroke – Tips on Prevention

Due to a significant decrease in overall activity level following a stroke, many people experience profound deconditioning.  Especially those with significant physical limitations that require them to sit in a wheelchair for most of the day.

This deconditioning includes:

• decreased cardiovascular efficiency (every activity seems to make you more tired and more out of breath than it used to)
• significant muscle atrophy on the more involved side
• decreased blood flow to the hands and/or feet
• osteoporosis
• your body becomes poor at regulating blood pressure and blood sugar.  (1)

So what can we do about it?

There are several challenges to overcome here.

FIRST, you need to find a way to increase your activity level, within the confines of your current disability.  In other words, you need to find a form of exercise that is safe for you.

Here are some ideas (please discuss with your doctor or PT before trying them):

• -stationary bicycle
• -elliptical machine
• -water exercise or water aerobics
• -video game exercises, like the Wii Fit
• -upper body ergometer
• -walking
• -propelling your wheelchair (with both arms, one arm and one leg, both legs, or any combination)
• -some type of stroke rehab equipment
• -treadmill walking (some treadmills have equipment to support your body in a harness for safety)
• -weight training (within your abilities, of course)

One form of exercise to AVOID, if you have any amount of paralysis in one of your arms, is over-the-door shoulder pulleys.  This activity can possibly contribute to shoulder pain in the hemiplegic arm.

SECONDLY, you might have difficulty with your energy level.  See my article about Fatigue

FINALLY – The loss of activity after a stroke not only affects overall conditioning, but can also have effects on range of motion.  Losing range of motion at a joint  (or joints) can limit your options for exercise/activity even further.  For example, if you develop a contracture of your hamstrings in one leg, this might prevent you from being able to pedal a stationary bicycle.  Get on top of this possibility of losing ROM early in your stroke rehab, so that it won’t become a problem later on!

An ugly snowball effect can occur after a stroke.  Disability can lead to deconditioning, which can lead to further disability, which can lead to further deconditioning, which can lead…..I think you get the point.  Try not to get trapped in this downward spiral.

For more info on the benefits of general exercise after a stroke, read my article:  “Stimulating Stroke Recovery Through Exercise”