Stroke Survivors Benefit From Regular, Brisk Outdoor Walks

A new study finds that taking regular brisk walks outdoors can help people recovering from a stroke to improve their physical fitness, enjoy a better quality of life, and increase their mobility.

The researchers, from the University of the West Indies in Jamaica, write about their findings in the 6 March online issue of the journal Stroke.

After experiencing a stroke, many survivors have less energy and walk less because of fear of falling. They also tend to reduce meaningful activity like going to the shops, visiting family and friends, or going to church.

Previous studies have already suggested that exercise that doesn't put undue stress on the body can help stroke survivors increase their quality of life, but these have mainly studied the effect of indoor activities such as walking on a treadmill or using an exercise bike.

"Little is known about the effects of community-based walking programs in persons with chronic stroke," write the authors.

So lead author and physical therapy lecturer Carron Gordon and colleagues decided to carry out a randomized controlled trial to investigate effects of aerobic training, namely walking outdoors, on stroke survivors.

They recruited 128 stroke survivors (70 women and 58 men) from three hospitals in Jamaica and randomly assigned them to the intervention group (64 members) or to the control group (64).

The participants, whose average age was 64, had suffered either an ischemic or hemorrhagic stroke six to 24 months before the study and could walk on their own with or without a cane.

Participants of the intervention group undertook supervised outdoor walking for 30 minutes three times a week for 12 weeks. At first they walked with supervisors, but eventually, friends or family members could walk along instead, until they were confident enough to walk on their own.

The participants in the control group just received massage to the side of their body affected by stroke and did not have supervised walking sessions.

Before and after the study, the participants' quality of life, fitness, mobility, strength and functional status were assessed using a mix of physical tests and standardized questionnaires. Blood pressure and heart rate were also assessed.

The results showed that compared to the controls, the exercisers reported a 16.7% improvement in health-related quality of life, and they walked 17.6% further in a six-minute physical endurance test.

The walking group also had a 1.5% lower resting heart rate at the end of the study than they did at the beginning, while the controls' resting heart rate went up 6.7%.

Gordon says in a press statement:

"Walking is a great way to get active after a stroke. It's familiar, inexpensive, and it's something people could very easily get into."

She explains that walking can help control blood pressure, reduce lipid or fat levels, and keep weight under control. All these are cardiovascular risk factors, "So doctors should encourage it for patients who have had a stroke".

Gordon says while most of the participants in their study were black and living in Jamaica, similar results can be expected in other ethnic groups living in other parts of the world.

But, it would not be reasonable to assume the same would be true of patients more severely affected by stroke or who can't walk independently, she cautions.

The American Heart Association recommends stroke survivors do aerobic exercise for 20 to 60 minutes, three to seven days a week, depending on fitness.

Research presented last month at the American Stroke Association's International Stroke Conference 2013, also suggests that practising Tai Chi may reduce falls among adult stroke survivors.