Risks of not exercising after stroke
• Reduced muscle strength and power
• VO2 max: about 50% of age-matched controls
• Difficulty with activities of daily living, e.g.
• Unable to cross the road fast enough
• ↑ risk of further vascular events
• ↑ risks of falls
• ↓ community integration
• ↑ Risk of hospitalisation
• ↑ Risk of long term complications.
Risks associated with exercise
• The same risks which are associated with
other co-morbidities e.g. Cardiac and OA
• The risks associated with stroke
impairment e.g. weakness, fatigue,
• The risks associated with activities and
stroke e.g. falls, pain
Benefits of exercise after stroke
• Improves physical fitness
• Improves walking performance (as long as
walking is included)
• Benefits are exercise-specific
• Subjective evidence of mood /
Current service models
There are 3 different stroke-specific service
models for Exercise after Stroke in Scotland:
– Rehabilitation extensions (NHS run)
– Leisure services (e.g. Glasgow “Vitality”
– NGO’s e.g. Different strokes, CHSS groups
Pathways into Exercise after Stroke
Discharge from hospital rehabilitation Community stroke survivors
Screening for absolute contraindications
Referral to EAS service
Complete a referral form Health care
Exercise after stroke sessions in leisure centre
Continue exercise after stroke sessions Mainstream exercise services
COMMUNITY PHYSICAL ACTIVITY PATHWAY
Patient identified who would benefit from increasing physical activity levels
Is patient ready to increase physical activity levels?
May not be ready now. Offer information on Does patient have any absolute contraindications?
Physical Activity and leave ‘open-door’ for e.g. BP ≥ 180/100mmHg, unstable angina, acute or
discussion in the future. chronic heart failure, uncontrolled tachycardia or
arrhythmia, uncontrolled diabetes etc.
Not for community physical activity No
programme until stable /reviewed by GP or
cardiologist as appropriate. Consider Would patient benefit from/wishes
Cardiac/Pulmonary rehab Services. behavioural change support?
Does patient have a history of
heart disease or stroke?
Offer Live Active Referral Scheme
12 months 1:1 behavioural change support via face to
No Yes - Re-emphasis role of face & telephone consultations & tailored activity goals.
Live Active Programme Use referral form or contact 0141 287 9873
Is patient interested in a Offer Vitality Programme
structured group activity? Suitable for individuals with long-term conditions & low
aerobic fitness/functional ability.
Offer help to complete PAR-Q form if required.
Signpost to Local Leisure Providers Individuals with established heart disease or stroke can
for info on activities e.g. gym, health only access this programme via the Live Active referral
walks, swimming. Reinforce ‘active scheme.
options’, e.g. walking, using the stairs etc Please Note: Vitality classes are group based only.
• Recommended by Skills Active
• Currently only 1 course endorsed – Later Life Training 6 day
course with qualification (& therefore insurance!)
• Available to AHPs & Exercise Instructors.
• Includes some workforce planning
• Ensures basic competencies
• Live Active Administrator
0141 287 9873
• Vitality Programme Co-ordinator
0141 287 9882
• Walk Glasgow Co-ordinator
0141 287 0963
• Culture and Sport Glasgow
0141 287 4350