The length of walking for a stroke patient

by Susan Greene
(New York new york)

Question: I am taking care of a lady who had a very massive stroke on her left side. This man who teaches, not a physical therapist, comes in to give her exercises, he want us to walk her in her home fifty times a day every day. Is that some thing that a patient should do?

Answer: I cannot comment on the particular patient you care for since I do not know her condition, but stroke patients should get up and move around as they are able. Fifty times sounds excessive in my opinion for a severely involved patient, but if you think about a person who is not disabled, they easily get up and down more than 50 times a day. What neuroplasticity research has shown is that repetition of movement/tasks is what helps "rewire" the brain so it is helpful to walk frequently if one is able (this includes with support from others).

As I said, I am not familiar with the particular patient you are caring for, but if you can safely help her get up and down and take steps (this includes without hurting yourself), then it is fine to let her walk as as she is able. You can always check with her physician if you have medical concerns about her doing this. I do want to clarify though that when you say "walk 50 times a day", I assume you are including walking to the bathroom, walking to the bedroom for sleeping, to the dining room for eating, or other rooms of the house as well as short walks/steps for exercise. Just walking back and forth to rooms to do daily activity could constitute 15-20 times a day. In my opinion, 50 times sounds like it is too much if she is severely involved as you describe, but I do not know her condition. If it is extremely difficult for her to get up and takes 15-20 minutes just to stand and take a few steps, then 50x a day would fatigue her too much and may not even be possible. Since you work with her on a daily basis, I would observe how she responds to walking and select a schedule that she can handle and that doesn't overly fatigue her. It is okay though to walk a stroke patient as much as they are able as long as they don't have any medical complications that would limit them from doing so.

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