Face to face and telephone-based self-management programmes were identified as having promise to engage stroke survivors in PA behaviour change .
Background Increasing physical activity ( PA ) levels ( regular movement such as walking and activities of daily living ) and reducing time spent sedentary improves cardiovascular health and reduces morbidity and mortality .
Fewer than 30 % of independently mobile stroke survivors undertake recommended levels of PA .
Sedentary behaviour is also high in this population .
We aim ed to systematic ally review the study characteristics and the promise of interventions targeting free-living PA and /or sedentary behaviour in adult stroke survivors .
Treadmill Aerobic Training Improves Glucose Tolerance and Indices of Insulin Sensitivity in Disabled Stroke Survivors: A Preliminary Report
Background and Purpose — Insulin resistance and glucose intolerance are highly prevalent after stroke , contributing to worsening cardiovascular disease risk and a predisposition to recurrent stroke . Treadmill exercise training ( T-AEX ) increases aerobic capacity ( Vo2 peak ) in chronic stroke patients , suggesting intensity levels that may be adequate to improve glucose metabolism . We compared the effects of a progressive T-AEX intervention to an attention-matched stretching intervention ( CONTROL ) on glucose tolerance and indices of insulin sensitivity in stroke survivors . Methods — Participants had hemiparetic gait after remote ( > 6 months ) ischemic stroke . They were r and omized to 6-month T-AEX or a duration matched reference CONTROL program of supervised stretching exercises . Main outcome measures were glucose and insulin responses during a 3-hour oral glucose tolerance test ( OGTT ) . Results — Forty-six subjects ( T-AEX=26 , CONTROL=20 ) completed OGTT testing before and after the interventions . T-AEX  increased Vo2 peak ( + 15 % versus −3 % & Dgr ; , P<0.01 ) compared with CONTROL . There were significant reductions in fasting insulin ( −23 % versus + 9 % & Dgr ; , P<0.05 ) and the total integrated 3-hour insulin response ( −24 % versus + 3 % & Dgr ; , P<0.01 ) in T-AEX compared with CONTROL . In patients with abnormal glucose tolerance at baseline , T-AEX result ed in a significant 14 % decrease in 3-hour glucose response ( n=12 , P<0.05 ) . Fifty-eight percent of T-AEX participants with abnormal baseline OGTT ( 7 of 12 ) improved glucose tolerance status at 2 hours compared with < 10 % ( 1 of 11 ) of impaired CONTROLS ( P<0.05 ) . Conclusions — These preliminary findings suggest that progressive aerobic exercise can reduce insulin resistance and prevent diabetes in hemiparetic stroke survivors . Larger clinical trials are needed to definitively establish the use of structured exercise training for stimulating metabolic improvement poststroke
Face to face and telephone-based self-management programmes were identified as having promise to engage stroke survivors in PA behaviour change .
Background Increasing physical activity ( PA ) levels ( regular movement such as walking and activities of daily living ) and reducing time spent sedentary improves cardiovascular health and reduces morbidity and mortality .
Fewer than 30 % of independently mobile stroke survivors undertake recommended levels of PA .
Sedentary behaviour is also high in this population .
We aim ed to systematic ally review the study characteristics and the promise of interventions targeting free-living PA and /or sedentary behaviour in adult stroke survivors .