Step Number and Aerobic Minute Exercise Prescription

How do we prescribe exercise to patients recovering from stroke while lowering their chances of additional complications from too much exercise?

Author’s Note: My name is Sneha Sivaramakrishnan. I am currently in my third year of studies in the Integrated Science program at Western University. This story is inspired by a research article titled, Step Number and Aerobic Minute Exercise Prescription and Progression on Stroke: A Roadmap. 

After experiencing a stroke, people are often left partially paralyzed, unable to speak with ease or even have memory loss. However, many of these patients have a spark within them to recover as soon as possible to regain their autonomy and individuality. Although it is common knowledge that exercise through rehab is the key to recovery, especially in the case of stroke, patients are often prescribed lower levels of exercise than what they may require. Clinicians underprescribe exercise to keep their patients safe, that is, performing high levels of exercise can increase a patient’s chance of risk of further complications.

To find a fine level of balance between prescribing exercise to patients with stroke and lowering their chances of complications, Dr. Sue Peters and her team have created a “Roadmap”. This roadmap is essentially a guideline that can be used by clinicians to prescribe optimal amounts of exercise over 20 rehab sessions. Interestingly, this roadmap offers customizable exercise regimes for each patient based on their metrics; their age, and walking speed after experiencing the stroke. For example, if a patient was 65 years old and had a walking speed of 0.4m/s, a clinician can expect that the patient can safely walk for 17 minutes on their first rehab session. By their last and 20th rehab session, the patient will be able to safely walk for 27 minutes and complete more than two times the amount of steps they were able to take during that first session. A fascinating observation in this study was that patients regardless of their age were able to move more and perform aerobic exercises longer than they had with each succeeding session. 

This research holds great promise in the realm of providing customizable exercise regimes to patients with stroke. With this roadmap in place, clinicians can confidently prescribe more exercise to speed up their patients’ recovery process and help restore their individuality. 

This work is openly licensed in the Creative Commons with an Attribution License by 4.0.