Articles
Reviewing the Benefits of Exercise
Sandra A. Billinger, PT, FAHA
For many years, exercise has been promoted to help reduce risk
factors for heart disease, hypertension, and stroke. In fact, many research
search studies have examined the effects of exercise on the human body and
found that exercise is beneficial. In 1992, the American Heart Association
stated that physical inactivity was considered a major risk factor for heart
disease (Ref. 1). It is recommended that every United States adult accumulate
thirty minutes or more of moderate-intensity physical activity on most, preferably
all days of the week (Ref. 1). For most people, choosing their mode of exercise
depends on the activities they enjoy doing such as swimming, walking, running,
or biking. However, a much more complex issue arises when an individual with
a disability decides on an exercise program. Many times, transportation, access
to facilities, and ability to use equipment may prevent individuals with a
disability from joining a health club. In fact, there some believe that emphasis
in health care and fitness has been directed at the primary prevention a disability
rather than at prevention or reduction of secondary health conditions in people
who have a disability (Ref. 2-5).
Because exercise is an important component in
reducing stroke, those individuals who have survived
a stroke know how difficult and challenging the
activities of daily living can be, let alone exercising.
Challenges may exist from weakness (hemiparesis),
spasticity, decreased balance, and fatigue. Unfortunately,
the sedentary lifestyle of some stroke survivors
negatively impacts their physical functioning,
which can rapidly decline if one is not active.
Moreover, the significant loss of muscle function
that results from hemiparesis or hemiplegia, stroke
survivors can have a severely reduced maximal or
peak oxygen uptake (Ref. 6). Fortunately, for those
survivors that can safely ambulate on a treadmill,
exercise programs have shown to reduce cardiovascular
demands, and may improve both functional mobility
and cardiovascular fitness for the stroke population
(Ref. 7). Also, motor impairments are quite common
and may inhibit the person’s ability to exercise.
Hemiparesis can impact the stroke survivors’ ability
to safely ambulate with or without an assistive
device. Instability with gait and/or balance can
impede the use of traditional means of exercising
such as treadmills or bicycles. However, the NuStep
can provide a safe mode of exercise for stroke
survivors. Stroke survivors can exercise on the
NuStep to improve cardiovascular function through
an aerobic workout (40%-60% of heart rate maximum).
The cushioned seat on the NuStep resembles the
design of a chair for comfort and safety since
it can swivel to both sides of the NuStep and allows
for transfers from a wheelchair. The NuStep is
ideal for individuals who are deconditioned by
a disability or an impairment that inhibits them
from exercising. The reciprocal motion of the NuStep
provides total body reciprocal training for the
upper and lower limbs. Currently, several studies
have examined the effects of total body reciprocal
training on grip strength, gait, balance, and cardiovascular
fitness levels in stroke survivors. Preliminary
data suggests a positive impact may result from
using the NuStep in a supervised exercised program.
References
1. Whaley M and Kaminsky L. Epidemiology
of physical activity, physical fitness, and selected
chronic diseases. In Roitman, J, editor. ACSM’s
Resource Manual for Guidelines for Exercise Testing
and Prescription. Philadelphia: Lippincott, Williams
and Wilkins. 2001; 17-35.
2. Rimmer J. Health promotion for people with
disabilities: The Emerging Paradigm shift from
disability prevention to prevention of secondary
conditions. Physical Therapy. 1997; 79(5): 495-502.
3. Brandon J. Health promotion and wellness in
rehabilitation services. J Rehabil. 1985; 51:54-8.
4. Stuifbergen A and Becker H. Predictors of
health-promoting lifestyles in persons with disabilities.
Res Nurs Health. 1994; 17:3-13.
5. Patrick D. Rethinking prevention for people
with disabilities, part I: a conceptual model for
promoting health. American Journal of health Promotion.
1997; 11:257-60.
6. Rimmer J and Nicola T. Stroke. In Meyers J,
Hebert W, Humphrey R, editors. ACSM’s Resources
for Clinical Exercise Physiology. Philadelphia:
Lippincott, Williams and Wilkins. 2002; 3-15.
7. Macko R, Desouza C, Tretter L, Silver K, Smith
G, Anerson P, Tomoyasu N, Gorman P, and Dengel
D. Treadmill aerobic exercise training reduces
the energy expenditure and cardiovascular demands
of hemiparetic gait in chronic stroke patients.
Stroke. 1997; 28: 326-30.
