Potential Benefits of Aerobic Walking Exercise on Cardiovascular, Pulmonary, and Bone Health in Non-Ambulatory Stroke Survivors: A Narrative Review

Abstract

Stroke is the leading cause of long-term disability worldwide. After stroke, people commonly experience additional cardiovascular disease, cognitive declination, sensorimotor disability, pulmonary dysfunction, psychological problems, and bone health declinations. In stroke rehabilitation research, most of previous studies focused on recovery of sensorimotor function, with few studies examined outcomes in cardiovascular, cardiopulmonary, and bone health, particularly in non-ambulatory individuals who are at even higher risk of secondary complications. In this narrative review, we reviewed the health benefits of aerobic walking exercise on cardiovascular, pulmonary, and bone health in non-ambulatory stroke survivors. We started with a review of health issues in cardiopulmonary system and bones in non-ambulatory stroke survivors. We then reviewed the current state of clinical research findings of aerobic walking exercise in non-ambulatory stroke survivors. We reviewed the aerobic exercise guidelines for non-ambulatory stroke survivors and whether walking exercise was recommended for them. Then, we investigated the exercise position (standing vs. sitting) to see which exercise position would be recommended to improve or at least maintain the health of cardiopulmonary and bone in non-ambulatory stroke survivors. We finally reviewed the walking assistive devices that makes walking exercise feasible for non-ambulatory stroke survivors.