09 October 2009

Walking helpful after stroke

People who suffer a stroke can substantially improve their ability to get around independently if they take walks a few times a week.

People who suffer a stroke can substantially improve their ability to get around independently if they take walks a few times a week, according to an updated review of the medical literature.

Strokes often occur in older people who have already lost some fitness and muscle strength. Suffering a stroke may further weaken an older person by causing partial paralysis and other neurological problems.

A previous, less definitive review of the medical literature published in 2004 found that walking could benefit stroke patients.

Cardio training beneficial
To update that analysis, Dr. David Saunders of the University of Edinburgh in Scotland and his colleagues reviewed 24 studies, which included a total of 1,147 stroke patients. The analysis focused on the benefits of cardio respiratory training (walking or cycling), strength training (free weights or resistance) or a combination of the two.

Cardio respiratory training produced clear benefits, Saunders and his team report in The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research.

Stroke patients increased their walking speed by about 5.6 yards a minute, and were able to walk 42.5 yards further in six minutes than study participants who didn't exercise.

In general, the stroke patients walked three or more days a week, usually for more than 20 minutes at a time.

There was no evidence, however, that working out with weights helped stroke patients function better.

"If you strength-train stroke patients, you can make them stronger, but there was no evidence of improvement in mobility and physical function," Saunders said in a statement from the Health Behavior News Service.

It's also not clear from the data whether the benefits of walking and other aerobic fitness programs would persist after a person stopped exercising, or whether exercising reduced the risk of disability and death.

Participants not the average stroke patient
Dr. Joel Stein of Weill Cornell Medical College in New York City, who was not involved in the review, notes that many stroke patients might have difficulty doing as much exercise as the study participants did.

Those who took part in the research, he added, may be more motivated and healthy than the average stroke patient.

Still, for stroke patients who can get around, walking is "the simplest and most relevant exercise," Stein told the Health Behavior News Service. – (Reuters Health)

SOURCE: The Cochrane Library 2009.

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