Aerobic exercise prescription for patients after stroke: Current scenario and barriers perceived by Brazilian physical therapists.

BACKGROUND

Guidelines recommend incorporating aerobic exercise into stroke rehabilitation. However, implementing this is challenging due to safety concerns, institutional and patient characteristics, and unfamiliarity with aerobic exercise guidelines. No study has assessed the parameters used and perceived barriers among Brazilian physical therapists when prescribing aerobic exercise for individuals after stroke.

OBJECTIVES

This study aimed to investigate how Brazilian physical therapists prescribe aerobic exercise for individuals after stroke and identify perceived barriers in clinical rehabilitation.

METHODS

A web-based cross-sectional observational study was performed, recruiting Brazilian physical therapists who had treated at least one individual after stroke in the last 3 months. The questionnaire was distributed via social networks.

RESULTS

79 participants were included (76% female; mean age 34 ± 8.3 years; 63% from the Southeast). Almost all (n = 78; 99%) agreed on the importance of incorporating aerobic exercise into stroke rehabilitation. Overground walking was the most prescribed aerobic exercise (89%). Moderate intensity (40%-59% of heart rate reserve) was the most common (51%) prescription. However, some respondents were unaware of the prescribed intensity (11%). On average, participants prescribed aerobic exercise for 44 ± 17 min, typically twice a week. The most cited barrier was cognitive dysfunction in individuals after stroke (58%). Only two participants reported no barriers.

CONCLUSIONS

Most Brazilian physical therapists recognize the importance of aerobic exercise in stroke rehabilitation. However, uncertainty regarding exercise intensity and multiple reported barriers challenge adequate prescription.