- The Cochrane review: At present there is insufficient evidence to support or refute the effects of routine very early mobilisation after stroke.
- An article looking at quality of life: Conclusions. Very early mobilization may help improve long-term quality of life after stroke, particularly in relation to functional independence, but this requires further examination.
- An article where they interviewed therapists, docs and nurses: Conclusion: Our study shows that most clinicians had concerns in relation to early mobilisation of stroke patients and more clinicians had concerns for haemorrhagic than for ischaemic stroke.
- An article looking at very early mobilization and depression: Conclusion: Very early mobilization may reduce depressive symptoms in stroke patients at 7 days post-stroke.
- Early mobilization out of bed after stroke may be all good: Conclusion: It seems to reduce severe complications but not cerebral blood flow:
- Early mobilization out of bed after stroke, maybe: Conclusions: Insufficient data are available to prove the beneficial effects of early mobilisation after stroke.
- A Very Early Rehabilitation Trial for Stroke (AVERT): Conclusions:Very early mobilzation of patients within 24 hours of acute stroke appears safe and feasible.
Recommendations for Exercise Programming
Exercise training for individuals with AD has three major considerations:
- to minimize problems arising from the declining physical and mental health of the participant
- to recognize behavioral changes that may cause the client to become agitated with the exercise program or the exercise setting
- to support caregivers’ willingness to continue bringing the person to the exercise program as the disease progresses
Thus, a low-intensity program at the client’s usual ADL levels is recommended. For this level of involvement, exercise testing is unnecessary.
During the early stages of AD, most clients should be able to participate in some form of physical activity. One of the most common problems associated with exercise programming for adults with AD is memory loss. Clients may forget to come to the exercise session or may find that they have forgotten how to perform certain activities. Depression is also quite common during the early stage of the disease and may result in the client’s withdrawal from the program. The cornerstones of an exercise program for this population are consistency, patience, and enjoyment. The exercise leader must constantly provide verbal encouragement and support to maintain the client’s interest in the program. During the early stages of exercise training, simple repetitive exercises like walking, riding a stationary bike, or lifting a certain amount of weight on various exercise machines will be easier than more complex routines (see table 48.2).
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