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NeuroRX

, Volume 3, Issue 4, pp 439–450 | Cite as

Exercise rehabilitation after stroke

  • Frederick M. Ivey
  • Charlene E. Hafer-Macko
  • Richard F. Macko
Article

Summary

Stroke is a leading cause of disability that results not only in persistent neurological deficits, but also profound physical deconditioning that propagates disability and worsens cardiovascular risk. The potential for exercise-mediated adaptations to improve function, fitness, and cardiovascular health after stroke has been underestimated: it represents an emerging arena in neurotherapeutics. To define the health rationale for cardiovascular (aerobic) exercise, we first outline the impact of debilitating secondary biological changes in muscle and body composition on fitness and metabolic health after stroke. We provide an overview of evidence-based advances in exercise therapeutics, with a focus on task-oriented models that combine a progressive aerobic conditioning stimulus with motor learning to improve multiple physiological domains that determine longitudinal outcomes after stroke. Although progress in development of safe and effective exercise strategies is advancing, fundamental questions regarding dose intensity, prescription to optimize central and peripheral neuromuscular adaptations, and the public health value of exercise in secondary stroke prevention remain unanswered. Key issues steering future research in exercise neurotherapeutics are discussed within the context of initiatives to facilitate translation to community-based studies, requisite for dissemination.

Key Words

Stroke exercise treadmill rehabilitation chronic disability 

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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2006

Authors and Affiliations

  • Frederick M. Ivey
    • 1
    • 2
    • 3
    • 4
  • Charlene E. Hafer-Macko
    • 1
    • 2
    • 3
    • 4
  • Richard F. Macko
    • 1
    • 2
    • 3
    • 4
  1. 1.Departments of Medicine and Neurology and Divisions of Gerontology and Rehabilitation MedicineUniversity of Maryland School of MedicineBaltimore
  2. 2.Veterans Affairs Medical Center (VAMC) Geriatrics Research, Education, and Clinical CenterUSA
  3. 3.VAMC Rehabilitation Research and Development Exercise and Robotics CenterBaltimore
  4. 4.Stroke Research Enhancement ProgramBaltimore

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