Post-rehab Exercise and Personal Training
by Michelle S.
Question: I am a personal trainer who has met with a woman who had a stroke seven years ago and has severely limited use of her left arm and leg. She's been cleared by her doctor and OT for all types of exercise that she wants/can do. I've read through your website -- very helpful and informative -- and would like to ask what advice you can offer as I work with this woman. She was extremely fit and active pre-stroke and has a strong desire to increase function and muscle mass. What precautions should I take, specific to her condition? I welcome any and all advice -- be it physical or psychological in nature -- on how best to help her improve her quality of life. Thank you for your time and input!
: I would not be able to give you precautions specific to the individual because each person is different in how they are physically affected and what pre-existing conditions they have. In general when working with a stroke patient, I would recommend monitoring blood pressure and heart rate. I would be careful with the affected shoulder especially with activities above 90 degrees of shoulder flexion as the shoulder blade may not be rotating properly to allow shoulder flexion/abduction above this range (this will need to be evaluated). Obviously the range of motion of a stroke patient will often not be the same as a client that has not had a stroke so be aware of range of motion limitations and pain. With limited use of the arm and leg, there will be balance issues, and the individual will be a higher fall risk. Stroke patients often have poor endurance due to lack of cardiovascular conditioning, so it is important to include some type of cardiovascular work. You can view recommendations for exercise for stroke patients at https://professional.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_463975.pdf