Physical activity in stroke patients: A scoping review

Ariyati Amin(1*), Rosyidah Arafat(2), Rini Rachmawaty(3)

(1) Department of Medical Surgical Nursing, Faculty of Nursing, Hasanuddin University, South Sulawesi, Indonesia
(2) Department of Medical Surgical Nursing, Faculty of Nursing, Hasanuddin University, South Sulawesi, Indonesia
(3) Department of Medical Surgical Nursing, Faculty of Nursing, Hasanuddin University, South Sulawesi, Indonesia
(*) Corresponding Author


Stroke is the second leading cause of disability and death worldwide with 5.9 million deaths annually. Stroke can be followed by various clinical problems. Impaired motoric function of the extremities is the most severe post stroke disorder experienced and impacts on limitations of daily activities. The main treatment is by doing regular physical activity exercises. This review was conducted to identify physical activities that can be performed by stroke patients. This scoping review was compiled using Arksey and O'Malley's five-stage framework. A total of three databases (i.e., Pubmed, Proquest, and DOAJ) was searched with relevant keyword "physical activity OR exercise AND stroke". The articles selected are published in the last 5 years, in English, and in full text. The literature search retrieved 164 studies to be screened based on the exclusion-inclusion criteria which finally resulted in the 11 studies included in the review. The remaining 11 studies were fully read and data were extracted regarding the type of physical activity, goals, settings and outcomes. Qualitative (i.e., theme analysis) methods have been used to synthesis the data. Based on the results of the review, there are several physical activities that stroke patients can do, such as progressive resistance and balance (PRB) exercises, locomotors exercises: (walking on a treadmill with body weight support and walking on the ground), selective movements of the upper and lower trunk body in the Supine and sit using a stable support / pad or unstable support (Swiss ball), core stability training, aerobic (AT) and resistance training (RT), aerobic training, walking exercises, and task-oriented training. Several physical exercises have been identified where each of these exercises has a purpose and benefit in the recovery of physical functional stroke patients. Physical activity should be done regularly and take into account the duration, intensity, and frequency of the exercise based on patient’s ability and stamina.


aerobic exercise; exercise; physical activity; resistance training; stroke

Full Text:



1. Bejot Y, Daubail B, Giroud M. Epidemiology of stroke and transient ischemic attacks: Current knowledge and perspectives. Rev Neurol (Paris). 2016;172(1):59–68.

2. Krishnamurthi R V., Ikeda T, Feigin VL. Global, regional and country-specific burden of ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage: a systematic analysis of the global burden of disease study 2017. Neuroepidemiology. 2020;54(2):171–9.

3. American Stroke Association. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke a guideline for healthcare professionals from the American Heart Association/American Stroke A. Vol. 50, Stroke. 2019. 344–418 p.

4. Jeon SH, Lee SM, Kim JH. Therapeutic effects of reaching with forward bending of trunk on postural stability, dynamic balance, and gait in individuals with chronic hemiparetic stroke. J Phys Ther Sci. 2015;27(8):2447-2451 5p.

5. Park GT, Kim M. Correlation between mobility assessed by the modified rivermead mobility index and physical function in stroke patients. J Phys Ther Sci. 2016;28(8):2389–92.

6. Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(8):2532–53.

7. Van Duijnhoven HJR, Heeren A, Peters MAM, Veerbeek JM, Kwakkel G, Geurts ACH, et al. Effects of exercise therapy on balance capacity in chronic stroke: systematic review and meta-analysis. Stroke. 2016;47(10):2603–10.

8. Belfiore P, Miele A, Gallè F, Liguori G. Adapted physical activity and stroke: a systematic review. J Sports Med Phys Fitness. 2018;58(12):1867–75.

9. Nozoe M, Kubo H, Furuichi A, Kanai M, Yamamoto M, Kobayashi M, et al. Physical activity, physical function, and quadriceps muscle thickness in male patients with sub-acute stroke during hospitalization: a pilot study. Eur Neurol. 2019;80(3–4):157–62.

10. Gothe NP, Bourbeau K. Associations between physical activity intensities and physical function in stroke survivors. Am J Phys Med Rehabil. 2020;99(8):733–8.

11. Han P, Zhang W, Kang L, Ma Y, Fu L, Jia L, et al. Clinical evidence of exercise benefits for stroke [Internet]. Vol. 1000, Exercise for Cardiovascular Disease Prevention and Treatment. Springer Nature Singapore; 2017. 187–210 p. Available from:

12. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2016;383(9913):245–55.

13. Saunders DH, Mead GE, Fitzsimons C, Kelly P, van Wijck F, Verschuren O, et al. Interventions for reducing sedentary behaviour in people with stroke. Cochrane Database Syst Rev. 2018;2018(4).

14. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett DR, Tudor-Locke C, et al. 2011 compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81.

15. Fitzgerald JD, Johnson L, Hire DG, Ambrosius WT, Anton SD, Dodson JA, et al. Association of objectively measured physical activity with cardiovascular risk in mobility-limited older adults. J Am Heart Assoc. 2015;4(2).

16. Young DR, Hivert MF, Alhassan S, Camhi SM, Ferguson JF, Katzmarzyk PT, et al. Sedentary behavior and cardiovascular morbidity and mortality: a science advisory from the American Heart Association. Circulation. 2016;134(13):e262–79.

17. Arksey H, O’Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol Theory Pract. 2005;8(1):19–32.

18. Rose DK, Nadeau SE, Wu SS, Tilson JK, Dobkin BH, Pei Q, et al. Locomotor training and strength and balance exercises for walking recovery after stroke: response to number of training sessions. Phys Ther. 2017;97(11):1066–74.

19. Vahlberg B, Cederholm T, Lindmark B, Zetterberg L, Hellström K. Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial. Disabil Rehabil. 2017;39(16):1615–22.

20. Karthikbabu S, Chakrapani M, Ganesan S, Ellajosyula R, Solomon JM. Efficacy of trunk regimes on balance, mobility, physical function, and community reintegration in chronic stroke: A parallel-group randomized trial. J Stroke Cerebrovasc Dis. 2018;27(4):1003–11.

21. Cabanas-Valdés R, Bagur-Calafat C, Girabent-Farrés M, Caballero-Gómez FM, Du Port De Pontcharra-Serra H, German-Romero A, et al. Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients. Clin Rehabil. 2017;31(11):1492–9.

22. Haruyama K, Kawakami M, Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients: a randomized controlled trial. Neurorehabil Neural Repair. 2017;31(3):240–9.

23. Marzolini S, Brooks D, Oh P, Jagroop D, MacIntosh BJ, Anderson ND, et al. Aerobic with resistance training or aerobic training alone poststroke: A secondary analysis from a randomized clinical trial. Neurorehabil Neural Repair. 2018;32(3):209–22.

24. Lund C, Dalgas U, Grønborg TK, Andersen H, Severinsen K, Riemenschneider M, et al. Balance and walking performance are improved after resistance and aerobic training in persons with chronic stroke. Disabil Rehabil. 2018;40(20):2408–15.

25. Mansfield A, Knorr S, Poon V, Inness EL, Middleton L, Biasin L, et al. Promoting optimal physical exercise for life: an exercise and self-management program to encourage participation in physical activity after discharge from stroke rehabilitation: feasibility study. Stroke Res Treat. 2016;(5).

26. Andreasen SC, Wright TR, Crenshaw JR, Reisman DS, Knarr BA. Relationships of linear and non-linear measurements of post-stroke walking activity and their relationship to weather. 2020;(2).

27. Israely S, Leisman G, Carmeli E. Improvement in arm and hand function after a stroke with task-oriented training. BMJ Case Rep. 2017;2017:1–7.

28. Thant AA, Wanpen S, Nualnetr N, Puntumetakul R, Chatchawan U, Hla KM, et al. Effects of task-oriented training on upper extremity functional performance in patients with sub-acute stroke: A randomized controlled trial. J Phys Ther Sci. 2019;31(1):82–7.

29. Bailey RR. Promoting physical activity and nutrition in people with stroke. Am J Occup Ther. 2017;1–5.

30. Fanchamps MHJ, Horemans HLD, Ribbers GM, Stam HJ, Bussmann JBJ. The accuracy of the detection of body postures and movements using a physical activity monitor in people after a stroke. Sensors (Switzerland). 2018;18(7).

31. Kantak SS, Sullivan KJ, Fisher BE, Knowlton BJ, Winstein CJ. Neural substrates of motor memory consolidation depend on practice structure. Nat Neurosci. 2010;13(8):923–5.

32. Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: Implications for rehabilitation after brain damage. J Speech, Lang Hear Res. 2008;51(1):225–39.

33. Powers SK, Howley ET. Exercise physiology: Theory and application to fitness and performance. tenth. Vol. 18, The American Journal of Sports Medicine. New York: McGraw Hill Education; 2018. 316–320.

34. Sherwood L, Ward C. Human Physiology: From Cells to Systems. Fourth. Canada: Saunders Elsevier; 2019. 965 p.


Article Metrics

Abstract views : 2027 | views : 1697


  • There are currently no refbacks.

Copyright (c) 2021 Journal of Community Empowerment for Health

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.