Welcome to the advice page of NHS Forth Valley Stroke Service
Exercise and stroke
Even if your mobility is restricted after a stroke, it is likely you will be able to carry out some form of exercise to improve your overall wellbeing. This guide explains how exercise can improve your health, and suggests types of exercise and resources to help you to be more active.
How can exercise improve my health?
Exercise can reduce your risk of having a stroke or transient ischaemic attack (TIA). Just 30 minutes of moderate activity five days a week can reduce your risk of stroke by over 25%. It also has benefits for your physical and mental health including:
• lowering your blood pressure
• lowering your cholesterol levels
• reducing your risk of health problems like heart disease and type 2 diabetes
• helping you to lose weight if you need to, and maintain a healthy weight
• increasing muscle strength and flexibility
• helping to reduce levels of anxiety and depression
• increasing your energy levels
• improving self esteem
• helping you to sleep better
Your choice of exercise will depend on your interests, your physical abilities and what is available in your local area. You may prefer to exercise outdoors or indoors, to exercise on your own or with others. If you want to be more active, you can try to move around more throughout the day, by doing things like walking the dog, gardening, or taking the stairs instead of a lift.
Before becoming more active or starting to exercise you should speak to your GP, particularly if you have not done any exercise for some time. The side effects of some kinds of medication may also affect your exercise choices.
Some types of exercise to choose from include walking, jogging, swimming and cycling. Some people enjoy going to the gym, playing a team sport or dancing. You can also use an exercise DVD or computer exercise game at home.
You can also try some types of exercise that improve flexibility, such as yoga and pilates.
How much exercise should I do?
Aerobic (raising your heart rate)
All adults, including those over 65, should try to be active daily. Aim for at least 150 minutes of moderate aerobic activity a week in total, or 75 minutes of vigorous aerobic activity.
• Moderate aerobic activity will raise your heart rate and make you feel warmer, but not too out of breath to speak. This can include cycling, walking, tennis and water aerobics. To achieve 150 minutes per week, you should do 30 minutes of physical activity five or more times a week.
• Vigorous aerobic activity makes you breathe hard, and you won’t be able to talk much while exercising. It can include things like football, singles tennis, running, aerobics and fast swimming. In general, 75 minutes of vigorous activity can give similar health benefits to 150 minutes of moderate activity per week.
As well as aerobic exercise, all adults need to do strength exercises on two or more days a week, aiming to work all the major muscles. You can do strength exercises at home, such as lifting small weights with your arms, or using a chair to support you doing leg exercises. You can also try using machines in the gym, with support from a trainer. To gain strength, you would need to repeat the exercises for a set number of times two or three times a week.
Some vigorous exercises count as both aerobic and muscle-strengthening, such as circuit training, running, football and aerobics.
To help improve your fitness, you can gradually build up the amount of exercise you do. Remember to have rest days, and if you have fatigue, try to be aware what can trigger your fatigue. Always stop an exercise if you experience pain.
Even if you take plenty of exercise, moving around during the day, and avoiding sitting for long periods if you can, is also important for reducing your risk of diabetes and heart disease.
When should I exercise?
Some people prefer exercising in the morning, some later in the day. Judging by how your body feels you will be able to decide what time suits you. If you plan your exercise so that it fits into your daily routine, you might be more likely to keep going with it.
Before you exercise, you can avoid injury to your muscles by:
1. warming up before starting, for example walking slowly for 10 minutes before brisk walking
2. cooling down afterwards by lowering the intensity of the exercise and letting your heart rate decrease
3. stretching out your muscles at the end
Food and drink
It’s a good idea not to do any exercise for about three hours after a main meal such as breakfast or lunch. An hour before exercising you could have a light snack containing some protein and carbohydrate, but low in fat. This could be yoghurt, a banana, or a glass of milk. Avoid foods that are fatty or hard to digest like crisps, nuts and raw vegetables.
Make sure you drink water regularly throughout the day beforehand, so you start your exercise well hydrated. After a session, replace lost fluids by drinking water. You could have milk or an isotonic drink if you exercised for more than an hour.
To help you stay motivated, it is important you enjoy your exercise activities. You may wish to do the following:
• try something new – perhaps you’ve always wanted to have a go at dancing, now’s your chance!
• get an exercise partner – see if a friend or family member can join you and you can encourage each other
• exercise to music – play some music you enjoy and the time will soon pass
• set yourself some goals and celebrate when you reach them. Your goal could be anything from walking further than last time, to keeping to your exercise plan for a week
• keep going – it might be hard at first, but it does get easier
• join a group – many people find being in a class or group makes an activity more enjoyable and social.
Exercising after a stroke
If you were already active or sporty before a stroke, whether you can go back to exercising the way you did before your stroke will depend on how your stroke has affected you. You may need to adapt your sports or activities, or try new activities. A physiotherapist or occupational therapist will be able to provide advice about adapting exercises, and finding new fitness activities you enjoy.
If you find it difficult to exercise while standing, you may be able to use an exercise bike or do seated exercises. Seated exercises can involve doing a series of stretches, as well as movements to increase your heart rate and exercise your muscles and joints.
You may find it helpful to join a class. Chair- based exercise classes can be held at local leisure centres, community centres, or in nursing or residential homes. Some stroke clubs also have exercise sessions at their meetings.
Is it safe to exercise if I have high blood pressure?
For most people with high blood pressure, exercise is safe and helps to reduce blood pressure.
If you have very high blood pressure, you should speak to your doctor before starting an exercise programme. You may need to reduce your blood pressure with medication before starting.
When you exercise your blood pressure naturally rises for a short time, but when you stop it soon returns to its usual level. The quicker it returns to normal, the fitter you are.
The best activities to reduce high blood pressure are aerobic exercises such cycling, walking and swimming. You can follow some of the tips in this guide to become more active and stay motivated to get fit.
Local leisure clubs and services
You can usually find out about local leisure facilities, exercise classes, parks and places to walk from your local council or library.
It’s worth finding out what is on offer at your local council leisure centre. Most sports centres run a variety of exercise classes to cater for a range of interests and fitness levels.
In many areas you will find a swimming pool and gym, and there may be other facilities you can use such as tennis, badminton and squash courts. Generally council facilities are cheaper than ones run by private companies, though commercial gyms and leisure centres may also offer competitive rates and discounts.
Many local councils offer discount schemes for older people, people with disabilities and people on certain benefits. There may also be schemes for new members.
This can enable you to take part in leisure activities, such as swimming, for free or at a reduced rate.
In a number of areas, local councils run exercise referral schemes. The schemes are aimed at people with medical conditions that may put their health at risk, and people with non-active lifestyles.
The scheme involves working with a trainer for a number of weeks. They will design an exercise program to suit your needs and provide you with support and guidance.
To find out whether there is a scheme in your area and if you would be eligible, speak to your GP.
Where to get help and information
From the Stroke Association
The Stroke Helpline is for anyone affected by a stroke, including family, friends and carers. The Helpline can give you information and support on any aspect of stroke.
Call on 0303 3033 100 or email firstname.lastname@example.org.
Stroke Association publications
The Stroke Association publish detailed information about a wide range of stroke topics including reducing your risk of a stroke and rehabilitation. Read online at stroke.org.uk or call the Helpline to ask for printed copies.
My Stroke Guide
My Stroke Guide is the online stroke support tool from the Stroke Association. Log on to find easy-to-read information, advice and videos about stroke. And our chat forums can connect you to our online community, to hear how others manage their recovery. Log on at mystrokeguide.com.
For support with registering or using My Stroke Guide, email email@example.com.
Take Life On (Scotland)
A Scottish Government website suggesting ways to live a healthier lifestyle, including how to get more active.
Other sources of help and information
Walking and running Jogscotland
Tel: 0131 273 3003
Jogscotland helps people get active by taking part in jogging groups.
Paths for All (Scotland)
Website: pathsforall.org.uk Tel: 01259 218 888
An organisation devoted to promoting walking and improving health in Scotland. On the website you can search for health walks in your region.
Website: ramblers.org.uk Tel: 0131 472 7006
A charity working to promote walking for health, leisure and transport and improve conditions for all walkers. Offers hundreds of walks each week from short strolls to longer treks.
Advice and support
A website developed by NHS Health Scotland to support health care professionals and patients. You can use the websites search function to find activities and groups in your area