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Stroke – Increased Independence

Evidence Summary
Increasing physical activity has been shown to increase independence and reduce dependence on others following stroke. A number of studies have demonstrated benefits from both cardiorespiratory and mixed training on participant on several different measures of “disability” and suggest that, following stroke, increased physical activity increases capacity in specific tasks like walking as well as more holistic measures of independence.

Quality of Evidence
Grade A-This recommendation comes from a synthesis of studies in the form of a Cochrane review and thus can be considered of high quality.

Strength of Recommendation
Grade 1- This recommendation comes from a synthesis of studies in the form of a Cochrane review and thus can be considered strong

Supporting increase in physical activity following stroke can result in improvements in function and reduced dependence on others. This may be helpful in empowering people after stroke to feel more in control of their daily lives.

• Saunders DH, Sanderson M, Hayes S, Johnson L, Kramer S, Carter DD, Jarvis H, Brazzelli M, Mead GE. Physical fitness training for stroke patients Cochrane Database of Systematic Reviews 2020, Issue 3. Art. No.: CD003316. DOI: 10.1002/14651858.CD003316.pub7.
• Bateman A, Culpan FJ, Pickering AD, Powell JH, Scott OM, Greenwood RJ. The effect of aerobic training on rehabilitation outcomes after recent severe brain injury: a randomized controlled evaluation. Archives of Physical Medicine and Rehabilitation 2001;82(2):174-82.
• Globas C, Becker C, Cerny J, Lam JM, Lindemann U, Forrester LW, et al. Chronic stroke survivors benefit from high intensity aerobic treadmill exercise: a randomized control trial. Neurorehabilitation and Neural Repair 2012;26(1):85-95.
• Gordon CD, Wilks R, McCaw-Binns A. Effect of aerobic exercise (walking) training on functional status and health related quality of life in chronic stroke survivors: a randomized controlled trial. Stroke 2013;44(4):1179-81.
• Katz-Leurer M, Carmeli E, Shochina M. The effect of early aerobic training on independence six months post stroke. Clinical Rehabilitation 2003;17(7):735.
• Mead GE, Greig CA, Cunningham I, Lewis SJ, Dinan S, Saunders DH, et al. Stroke: a randomised trial of exercise or relaxation. Journal of the American Geriatrics Society 2007; 55(6):892–9
• Mudge S, Barber PA, Stott NS. Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2009;90(12):1989-96.