The benefits of exercise are remarkable and wide-ranging. Physical activity improves heart function and lipid profile by lowering total cholesterol while raising HDL (good cholesterol). It lowers blood pressure and resting heart rate. Being active reduces the risk and severity of diabetes by increasing insulin sensitivity, and it improves strength, balance and endurance. For stroke survivors these benefits can spell the difference between dependence and independence.

In addition to those physical benefits, exercise can enhance self-confidence and independence and reduce depression and anxiety. As survivor Lorraine Essig, 87, said, “I can be in a bad mood but after I’ve done my exercise that disappears.”

Since Lorraine’s stroke seven years ago she works out three days a week despite right-side weakness and challenges with her balance that requires her to use a cane.

She starts with 10 minutes of pedaling on a portable exercise cycle she puts in front of her chair. Then she does a balancing exercise – standing on both feet, she raises her arms to shoulder height, closes her eyes and counts to 60. Holding on to her walker, she does 20 steps in place bringing her knees as high as the handholds on her walker. Then she does a routine of 14 exercises 20 times each; she increases benefit by adding 2.5 lb weights strapped to her wrists or ankles depending on the exercise. “I started out doing each one 30 times, but it tired me out too much,” Lorraine said.

Expert Testimony:
Survivors should get clearance before starting a physical activity program. “See your doctor first,” said Dr. Dorian Rose, a physical therapist with a Ph.D. in biokinesiology and research assistant professor in the College of Public Health and Health Professions at the University of Florida. “But don’t let that step be a barrier to exercising. Most physicians will be thrilled to hear that their patients are interested in exercising. Most physicians will be thrilled to hear that their patients are interested in exercising.”

One size doesn’t fit all
Many survivors with disabilities and put off by the general physical activity prescription of 30 – 45 minutes of aerobic exercise most days of the week. Physiatrist Dr. Elizabeth Pegg Frates is assistant director of medical education for the Institute of Lifestyle Medicine and a clinical instructor in the Department of Physical Medicine and Rehabilitation both at Harvard School of Medicine. She emphasized that most survivors are capable of some activity depending on their functional abilities. “The exercise prescription needs to be individualized for each survivor based on interests, strengths and current level of fitness,” Dr. Frates said. In her book “Life After Stroke: The Guide to Recovering Your Health and Preventing Another Stroke”, she and her co-authors created four categories to help with selecting an appropriate type of physical activity. The four categories are:
1. Severe functional limitations
2. Moderate functional limitations
3. Mild functional limitations
4. No functional limitations

Contact American Stroke Association for the September/October 2008 issue and the complete article by Clicking Here .

After a stroke most survivors are eager to go home and resume their lives. But if the home isn’t safe and comfortable, chances of a fall are high. Even people who regain their movement may have trouble due to problems with balance, memory, or thinking. The good news? Even minor adjustments at home can make a big difference.

Just as every stroke patient is unique, every living situation is different. That’s why it is a good idea to consult an occupational therapist (OT). A meeting with an OT may take place at the hospital or in the home.

“Safety is always our first and foremost concern,” said Nancy Hildreth an occupational therapist and a program director at the Veterans Administration Medical Center in Minneapolis Minn. “An occupational therapist can evaluate the patient’s skills and abilities to perform daily activities as well (the) communication links with others. For example it’s important to take into account if the person will be living alone or with other family members. After assessing the patient’s living skills, we’ll recommend any changes to the physical environment and possibly recommend adaptive equipment.”

Home modifications don’t have to be drastic or expensive. Minor changes can greatly improve safety in a home. This can include rearranging furniture, taping down electrical cords, and improving lighting.

For stroke survivors who use a wheelchair or walker, carpeting or slippery flooring may need to be taken our or adapted. Removing clutter, especially in walk-ways and stairways, can reduce the risk of falls and injury. Some people may need to relocate their bedrooms, widen doorways, or install ramps. The trick is to allow sufficient room to move and turn around as needed.

“Open space is a huge issue for patients with mobility problems” Hildreth said.

For survivors with even minor mobility problems, an OT often will recommend adaptive equipment such as grab bars and railings in bathrooms.

Always consult with an OT before modifying any home. An OT can provide tips and specifications and may recommend contractors or even an organization that may build ramps or do modifications for no charge or at reduced rates.

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If you are a stroke survivor or caregiver, Stroke Net would love for you to submit your favorite recipes to their site. Read More .

Read a “review” of the newsletter by Audrey Holland, Professor Emerita,University of Arizona:

You are marvels! I just read the newsletter for the month [11/07], and it is simply priceless (I always read them, and they are all noteworthy, but this one is beyond good.) Paul, your book is in my book as something that all cliniciansshould have, read, pass on (ie, make them buy) to their clients.

Stroke/Aphasia Reading problems?

After a stroke, many people have reading and other language
problems, known as “aphasia.” Hearing a sentence read aloud
helps to understand it. You can hear this newsletter read
aloud while each word is highlighted on the computer screen
with the FREE text reader software described at: www.strokesurvivor.com/disability_access.html .

Paul of “Stroke Survivor” had a stroke and learned how hard it is to deal with your emotions, feelings, and relationships. Speech problems (aphasia) make it worse…for both the survivor and their family and friends.

The first step, Paul says, to an attitude upgrade is to say “thank you” in person, by phone, and by mail. Email is great, but a card delivered to the door is a keeper, especially one with an inspirational picture and heartfelt words. Click on the above link to order the Gratitude Tool Kit –specially designed for people with language challenges. Gratitude Tool Kit

Bikes for those who are disabled goes beyond mere transportation, or even health building recreation for those whose health is often fragile. These specialized bikes create a sense of freedom for those who are disabled. Bikes restore a sense of possibility and ability to those whom are often told by society that their life is about limitations and disability.

At Project Mobility, they specialize in helping you find the right equipment solution for your specific needs. Custom fitting is an integral part of what they can do for you. Seating, adaptations and modifications are only part of the services they offer. Fittings by appointment. Learn more from Project Mobility

Call Project Mobility at (630) 762-9807 or email Hal Honeyman at: hal@projectmobility.org.

LinguiSystems is the first company to be founded and operated by speech-language pathologists. They vowed to always have the products you need and the tests you want, to guarantee them forever, and to give you the service you deserve.

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