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Role of Physical Therapy for Stroke

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Submitted By cece1434
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Running Head: Physical Activity and Stroke

Physical Activity in the Prevention and Treatment of Stroke

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University Name

Abstract

Researchers and scientists have always favored preventive measures to avoid the conditions which result in undergoing a rigorous treatment. In this view physical activity or fitness training programs have been found having significant effects in the prevention of strokes as well as at post care stage as treatment and a measure of rehabilitation in survivors of cardiac arrests. Further, it has been noted in recently conducted studies that quite a remarkable evidences are discovered in favor of physical activity as therapeutic as well as rehabilitative in nature. Organized physical activity in the form of exercise, tailor made programs according to the needs of the patients at post care stage and fitness training exercise therapy have been found considerably helpful in rehabilitation in the survivors of stroke. In addition, further research is proposed to explore the different types of organized exercise programs according to the physical and mental conditions of survivors and as preventive measures among them.

Physical Activity in the Prevention and Treatment of Stroke Cardiac arrest is a one of the growing and leading causes of death around the globe. According to available data, more than 130,000 people suffer from heart attack, from mild to severe strokes, every year, (SIGN, 2008). One cannot ignore preventive measures; however, once a person goes through a severe form of arrest, he needs post care mostly in form of therapeutic rehabilitative treatment. Developing strategies and organized programs are great challenges for scientists and practitioners around the globe. The vague connection between cardiac arrest and exercise is an interesting juncture for doctors, researchers and therapists. Physical activity has been found to reduce the five important key factors of stroke which are the cause of 80% of the strokes among people, (Ford, 2002). As a result, the pathogenesis of stroke has roots in hypertension, obesity, dyslipidaemia, mental stress and diabetes, (Lakka and Laaksonen, 2007). Physical activity and training as an organized program has been recommended as an important aspect in rehabilitation plans. In addition, this study will explore the necessary connection and mechanism between organized physical activity program and stroke with reference to prevention and treatment as post care.

Review of literature

According to the studies done by American Heart Association, 30% of the strokes have the recurrence tendency, (Thom, 2006). Among the most important established risk factors of stroke is hypertension. Physical activity causes to regulate blood pressure and consequently lowers down the risk factor. Regular exercise increases nitric oxide synthase improving endothelial function, reducing ventricular hypertrophy and activating HDL concentration. This condition has great deal of chances to cause hypertension and eventually leading to cardiac arrest. It has been observed in the patients that physical activity play an important role to prevent or lower down the risk of further strokes, however, the connection is still needed to be validated by research and proper evidence. The recorded evidences and other studies done in this respect also validate that there are putative pathophysiological benefits of exercise, (Sanossian and Ovbiagele 2006). A recent study has displayed a significant improvement in motor skills after stroke that causes resulted partial or complete paralysis in patients by applying organized high intensity physiotherapeutic activities using mental imagery and physical response. It has been observed that physical activity or repetitive nature produces electro-stimulation and improve control, (Page, Levine, 2007). However, there are no sufficient evidences available of the effectiveness of repetitive task training in prevention of further strokes and rehabilitation of survivors. More such studies and researches are needed to establish evidence based practices. In another study it has been established that moderate physical activity at workplace and intensive physical activity in the leisure time have significant positive effects in lowering the risk of stroke. There is 36% more risk of stroke if you remain inactive at workplace. Whereas, there is 20-25% reduction in risk of stroke in comparison to leisure time physical activity to inactivity. In addition, these effects lack proper evidence based research particularly time factor and intensity of physical activity. Cohort and case studies also have explored the gender based differences in frequency of strokes. In men 27% reduction in the risk factor of stroke has been noted, and in women 24% reduction has been recorded because of physical activity, (Sattelmair, Kurth, Buring, 2010.)
Research question How much an organized physical activity like aerobics, exercise programs and fitness training program is helpful in prevention and treatment as post care measure in strokes?

Hypothesis

It has been found that physical activity and exercise has a great effect in the treatment and prevention of strokes. They have a connection at the level of management of blood pressure and cardiovascular activity. Physical activity or a fitness training program seems to produce such effects in the mind and body of potential stroke candidate that it lowers down the risk factor to its minimal level, at least in normal conditions of life, and work as therapeutic pre and post effective measure in strokes. It is still unclear how to prevent further strokes in a patient. However, there has been increasing evidence that physical activity in the form of organized physical fitness training program help to a great deal to prevent further strokes.

Sampling and data collection plans

A computer assisted search study is planed where information will be collected using data available in the database of Ovid MEDLINE and EBSCO from 1950 to 2010. Similar studies and online journals providing relevant information will be taken into account to collect broader database for collection of data. After examining available data a potential connected is sought to be identified between physical activity and stroke.

Ethical considerations

There is a great danger to be insensitive or avoid high standards of ethics in medical research in the modern times. However, professionally and morally, avoiding these standards would have adverse effects on the findings of research as well as credibility of the finding may suffer. One is bound to follow principles of honesty, integrity, respect, secrecy regarding patent’s data and identification and acknowledgement of sources of data. A cautious approach to collect, compile and interpret data is required. Keeping the confidentiality of patients’ personal data, along with their identification and history records is important. Acknowledgment of sources and relevant studies on similar or related topics should be mentioned in paper.

Conclusion This study will explore the potential connection between stroke and physical activity as prevention and treatment. Organized fitness training programs and repetitive physical activity are said to have considerable effects on survivors of strokes. This study will establish a concrete connection, or otherwise, by providing credible evidence based on searched data and findings.

References

Atlantis, ECASS, and NINDs rt-PA Study Group Investigator, (2004), Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials, The Lancet, vol. 363, pp. 768–774, November 13, 2013.
B. T. Volpe, D. Lynch, A. Rykman-Berland et al., (2008) Intensive sensorimotor arm training mediated by therapist or robot improves hemiparesis in patients with chronic stroke, Neurorehabilitation and Neural Repair, vol. 22, no. 3, pp. 305–310, November 13, 2013. View at Publisher · View at Google Scholar · View at PubMed
J. E. Manson, P. Greenland, A. Z. LaCroix et al., (2002), Walking compared with vigorous exercise for the prevention of cardiovascular events in women, The New England Journal of Medicine, vol. 347, no. 10, pp. 716–725, View at Google Scholar. November 13, 2013.·
J. H. Rimmer, A. E. Rauworth, E. C. Wang, T. L. Nicola, and B. Hill, (2009), A preliminary study to examine the effects of aerobic and therapeutic (Nonaerobic) exercise on cardiorespiratory fitness and coronary risk reduction in stroke survivors, Archives of Physical Medicine and Rehabilitation, vol. 90, no. 3, pp. 407–412, November 13, 2013. View at Publisher · View at Google Scholar · View at PubMed
J. R. Sattelmair, T. Kurth, J. E. Buring, and I. M. Lee, (2010) Physical activity and risk of stroke in women, Stroke, vol. 41, no. 6, pp. 1243–1250, November 13, 2013.
K. C. Stewart, J. H. Cauraugh, and J. J. Summers, (2006), Bilateral movement training and stroke rehabilitation: a systematic review and meta-analysis, Journal of the Neurological Sciences, vol. 244, no. 1-2, pp. 89–95, November 13, 2013.
N. M. Salbach, N. E. Mayo, S. Wood-Dauphinee, J. A. Hanley, C. L. Richards, and R. Côté, (2004) A task-orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial, Clinical Rehabilitation, vol. 18, no. 5, pp. 509–519, November 13, 2013.
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S. Masiero, A. Celia, G. Rosati, and M. Armani, (2007), Robotic-assisted rehabilitation of the upper limb after acute stroke, Archives of Physical Medicine and Rehabilitation, vol. 88, no. 2, pp. 142–149, November 13, 2013.
Scottish Intercollegiate Guidelines Network (SIGN), Management of Patients with Stroke or TIA: assessment, Investigation, Immediate Management and Secondary Prevention. SIGN 108, A National Clinical Guideline, Edinburgh, UK, (2008). November 13, 2013 View at Publisher · View at Google Scholar · View at PubMed T. A. Lakka and D. E. Laaksonen, (2007), Physical activity in prevention and treatment of the metabolic syndrome, Applied Physiology, Nutrition and Metabolism, vol. 32, no. 1, pp. 76–88, 14 November, 2013. View at Publisher · View at Google Scholar · View at PubMed
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T. Thom, N. Haase, W. Rosamond, (2006), Heart disease and stroke statistics, Circulation, vol. 113, no. 6, pp. e85–e151, 12 November 2013, Report from the American Heart Association.

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