How much physical activity should I do?

seniors_park_fitness

One you have decided on a physical activity you are comfortable with you may have a few questions about how much you should do. Select the questions below for some advice.

How do I find out more?

    Generally speaking, the more you can do the better! You may find that after your stroke, your fitness is lower than it had been before your stroke, so you may need to start slowly and then gradually increase your activity. It’s important to aim high though!

How can I Increase my physical activity?

    You can increase your physical activity by:

  • Increasing the frequency of what you do e.g. rather than brisk walking just once a week, increase it to twice a week and so on.
  • You can also increase the duration of your activity-so rather than spending 10 minutes doing exercise, increase the length of each session of exercise-aiming to do at least 30 minutes.
  • You can also increase the intensity of what you do-so rather than walking slowly, start to walk briskly instead.
  • As you increase what you do, you may find that you feel slightly puffed or tired, but as your body becomes fitter, you will find that you can do more without feeling tired or puffed out.

How much activity is considered ‘enough’?

    This is a good question. Generally the more you do the better. It would be reasonable to aim to do 30 minutes of exercise, ideally 5 times a week, and the exercise should make you feel a slightly puffed out. However, if you can’t manage this much, aim to build up gradually.

What sort of physical activity should I do?

    It is recommended doing a range of exercises that will improve balance and strength as well as aerobic fitness. For further advice, you may wish to discuss with a fitness instructor.

Key point

For more ideas about how to increase your activity, there is lots of useful information on the Scottish Government website

In the house

Meet Isobel. Isobel has had to overcome some difficulties following her stroke in order to become more active. Lets see how she has got on. Tap on the picture to find out what Isobel’s advice is.

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My arm doesn’t work properly. I find that making sure that my arm rests in a natural position when I’m not using it helps to keep it relaxed and more comfortable. This also helps to keep swelling down in my hand. Using the arm of a chair or cushion under my elbow supports my shoulder, which can get sore if the arm hangs down.

My legs are stiff. I find that if I bend my legs up and down when I am sitting before I get up and walk it is easier. I also pace myself so that I am not getting too tired as this can make my legs stiffer. Drinking plenty of fluids like water can also help.

My ankles get really puffy as the day goes on. My nurse told me that puffy feet and ankles are really common if you have to sit for a long time. I often put my feet up on a stool or on the sofa and move my feet in circles. It really helps. I try not to sit too long and make myself get up for walks around the house. That gets the blood pumping and improves my circulation.

I am afraid I will trip. I find that if I take some precautions I feel less like I’m going to trip. I always make sure that I am wearing shoes or slippers that fit me. I had swollen feet in hospital, but this has gone down now and I had to replace my slippers as they had stretched! A good Christmas present from my daughter! Making sure rugs and furniture that could get in my way were moved, helped too.

My arm does not move as well as it used to. Because my arm is weaker after my stroke it does not move as well as it used to and it makes doing things harder especially as it is my right hand and I am right handed! What I try to do is still use it as much as possible when doing things. When I am watering my plants I put my weaker hand on the watering can and use my strong hand to help move it.

My muscles are weak. Because of my stroke I find it hard to move around, but if I sit in my chair all day I get stiff! I have found that even small amounts of movement and stretches help. I started by standing up during the adverts on TV. I noticed a difference quite quickly. I also set an alarm clock every 20 minutes to remind me to get up and move


 

Something to think about

Do any of Isobel’s challenges sound familiar to you? Why not try some of her suggestions.

Key point

Small and frequent movements in and around your house can help improve your fitness.

I want to make healthy eating choices- tips

Tips to improve your diet

Tips Ways to improve your diet
Reduce salt Salt can increase your blood pressure and your risk of stroke. You should have no more than 1 teaspoon (or 6g) a day. Often salt is ‘hidden’ in what we eat. Get into habit of checking labels to see how much salt is in that item. instead of using salt in your cooking, or adding it to cooked food, you can use lemon juice, garlic, herbs and spices. Reduce salt
Switch to wholegrain Switch to wholegrain: Instead of eating white bread, cereals, pasta and rice, switch to wholegrain bread, cereal, pasta and rice. Wholegrain food often has more vitamins and minerals than white bread, for example. Wholegrain food is also a good source of fibre which can lower cholesterol and risk of stroke. Wholemeal/brown bread
Steam, grill, bake or poach Frying your food can add fat and calories and may cause you to put on weight. Being overweight increases your risk of developing health problems – including type 2 diabetes, high blood pressure, heart disease and stroke. To help you lose weight and eat more healthily try to grill, steam, boil, stew, microwave or bake your food. Salmon fillet
Go for good fats We need some fat in our diet but too much of the wrong type of fat (saturated fat) can raise cholesterol and increase risk of stroke. Saturated fat is found in full fat dairy products, cakes and pastries and takeaway food. Good fat (unsaturated fat) is found in nuts and seeds, and oily fish like tuna, mackerel, and salmon. Selection of nuts
Replace red meat with leaner meat Choose lean meats such as chicken, turkey and game which have less saturated fat than red meat (beef, pork, lamb, goat). When you re preparing meat remember to cut off visible fat, and remove the skin from chicken or turkey. Roast chicken
Snack on fruit and veg You should try to have less than 60g (12 teaspoons) of sugar a day. Snacks often contain large amounts of sugar – a can of fizzy drink can have to 8 teaspoons. Try to get into the habit of swapping fizzy drinks, biscuits and cakes for a portion of fruit or raw vegetables. You could have an apple, or handful of grapes, or try a small portion of humous with dipping sticks of raw carrot and pepper. Remember: eating 5 or more portions day of fruit and vegetables can reduce your risk of stroke. Selection of fruit and vegetables
Medicines Some medicines can be affected by different types of food and drink. If you take statins, you should avoid drinking grapefruit juice. If you take warfarin you should not make sudden changes to your diet. Spinach and broccoli are high in vitamins but if eaten in large quantities can interfere with the effects of warfarin. disc_tablets

More information


Chest Heart & Stroke Scotland factsheets:

NHS:

Research papers:

Download the healthy eating tips sheet [.pdf, 135 KB]

Remembering to take my medicines

Taking your medication reminders

Some people have lots of medication and it can be difficult to keep track. There are lots of ways you can prompt yourself to remember. Such as:

  • A note on the fridge
  • Writing it on the calendar
  • Keep the medicines where they’re easy to find
  • Make them part of your daily routine

If you’re having difficulty remembering which medicines to take when, speak to your pharmacist who may be able to give you further advice or a device to help you, such as a dosette box.

Something to try

Some mobile phones have calendars on them that can make an alarm go off at the same time every day with a message saying what tablets you should be taking.
There are lots of apps for tablets and smart phones – some are free.

Try printing the ‘My Medications sheet’ with the details of your medicines and when you take them, or ask someone to help you do this.

Something to think about

Would any of these ideas be useful for you? If you are forgetting to take your medication regularly it may be worth giving them a try.

Download My medicines sheet [.pdf, 69 KB]

Relationships with the people in my world

Q. Lets now look at your relationships with the people in your world. Fill out a name below, select 6 words that best describe them and then select ‘Finish’.

Add

2. Select 6 words that best describe this person, your relationship with them and how they make you feel.

  • Close
  • Sad
  • Critical
  • Supportive
  • Distant
  • Overbearing
  • Encouraging
  • Helpful
  • Solid
  • Listens
  • Difficult
  • Get me down
  • Get on my nerves
  • Helps me
  • Hard work
  • Happy
  • Trust
  • Gives me a hard time
  • Frustrating
  • Understanding
Start again
Finish

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Think of a person in your world. Choose the words that best describe this person, your relationship with them and how they make you feel.

Positive words Negative words
CLOSE
SUPPORTIVE
HELPS ME
HAPPY
HELPFUL
SOLID
ENCOURAGING
UNDERSTANDING
TRUST
LISTENS		 SAD
GET ME DOWN
CRITICAL
DISTANT
HARD WORK
OVERBEARING
GET ON MY NERVES
DIFFICULT
GIVES ME A HARD TIME
FRUSTRATING

Feedback: if you chose mostly positive words
It looks as though you have good relationships with this person. That’s great it’s important to have supportive people around us.
Has your relationship with these people always been so good? Understandably, we often concentrate on the negative impact of stroke but in some circumstances it can strengthen relationships and bring people closer together.
Feedback 2: if you chose some positive and negative words
It looks as though your relationship with this person has some good and bad points. Think about the words you used to describe these relationships; could these relationships be improved?
Has your stroke had an impact on this relationship? Before your stroke would you have picked different words to describe this relationship, how have things changed?
Feedback 3 : if you chose mostly negative words
Your relationship with this person doesn’t look too great; is this surprising to you?
Is this since your stroke or was it a difficult relationship before? Do they know how you feel – have you tried talking to them? Communication is really important in all relationships. See the section on Talking and Sharing for some tips and advice.

Progress: looking back and forward

Goal setting plan

1. What is my goal?
I want to feel happier
2. Where am I at just now?
Date: 23 March
  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
3. My action list
By when?
  • Spend time with my grandchildren
  • Meet my friend regularly for coffee
  • Go for a swim
  • Weekly
  • Weekly
  • Weekly
Action
Meet Susan Tuesday, 10am café
4. How am I doing?
Date: 02 Sept
  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
5. What’s next on my list?

Rosie, looking happier
Now Rosie has carried out her action i.e. Meet Susan on Tuesday at 10am at the café.

Time to celebrate!

Rosie thinks about how it went; it’s working so she can keep going with it!  She rates herself again scale 0….10

If it hadn’t worked could Rosie think of a way round it? For example, her friend could come to her house and have a coffee with her or pick her up and take her out for a coffee.

Now she can plan her actions for the week ahead.

How to become more assertive

There is a difference between being assertive and being aggressive or angry and frustrated.

Q. Which of these is being assertive?. Select Yes or No for each one.
1.
I am always good at listening to others.
2.
I like to control and dominate the conversation.
3.
I would say “This is how we ARE doing it, so tough!”
4.
I would say “We could do it this way”.
5.
I would say “I don’t mind, whatever you think”.
6.
I get tense and stare when in a discussion.
7.
I try to relax and keep good eye contact when in a discussion.
Start again
Reveal answers

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  • I am always good at listening to others. (Feedback: yes, it is important to respect others opinions and share a conversation)
  • I like to control and dominate the conversation. (Feedback: it is important to respect others opinions and share the conversation)
  • I would say “This is how we ARE doing it, so tough!” (Feedback: this could appear quite aggressive )
  • I would say “We could do it this way”. (Feedback: yes, you are offering your opinion clearly)
  • I would say “ I don’t mind, whatever you think”. (Feedback: if things are important to you, you should give your opinion)
  • I get tense and stare when in a discussion. (Feedback: body language is important in conversations and you may want to work on this)
  • I try to relax and keep good eye contact when in a discussion. (Feedback: yes, body language is important in conversations and it is worth considering, particularly in more stressful situations)

Key points

  • It is important to respect others opinions and share a conversation
  • If things are important to you, you should give your opinion
  • Body language is important in conversations and it is worth considering, particularly in more stressful situations

Things to think about

Three ladies engaging in conversation

© Crown copyright 2009

  • The people who are important in our lives can alter after a stroke.
  • Following a stroke relationships often change. On occasions they become stronger but often they are put under pressure.
  • It is important that we make the most of our relationships and good communication is often the key.
  • Even relationships we currently see as being difficult can be improved if there is a willingness to sit down and discuss the issues.

Key point

Socialising after a stroke can be a challenge. However, we know that spending time with other people helps our well being so it’s important to make the most of your relationships.

Keeping a record

Keeping a record of your sleep, which can also be called a sleep diary, helps you look in more detail at how you are sleeping.

So how can a sleep diary help you?

By recording in more detail your sleep pattern and habits, a sleep diary can help you see the connection between your habits and your sleep.

Let’s look at how Scott used his sleep diary…

Scott has problems sleeping following his stroke. Select the arrow keys to see what Scott did to help him sleep.
Scott is having difficulty sleeping.Scott decides to visit his GP for advice on how to get a better night's sleep. His GP Suggests trying a sleep diary.Scott fills in his sleep diary.Scott and his GP review his diary and identify ways to improve his sleep.Scott tries his GP's suggestions and is getting a better night's sleep.

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Scene 1: Scott: “I don’t know why I keep on waking up so early and I can’t get back to sleep. Maybe my GP can give me something to help me sleep.”
Keypoint: Scott is having difficulty sleeping. (Scott is sitting on the edge of his bed, the clock is showing 3am. Scott looks tired).

Scene 2: GP: “It sounds like this has been going on for a while. Let’s try a sleep diary as it will tell us more about what might be causing you to wake up.”
Keypoint: Scott decides to visit his GP for advice on how to get a better night’s sleep. His GP Suggests trying a sleep diary. (GP passes Scott a sleep diary).

Scene 3:

Scott’s Sleep Diary

Date: 07/03/15 Bedtime: 11pm Wake time: 3am Duration of sleep: 4 hours
Number of times awake at night: 2 Quality of sleep: Disturbed
Caffeine intake and time taken Alcohol intake and time taken Food/drink intake and time taken How are you feeling? Medications
4 mugs of coffee and 2 cups of tea throughout the day. Last taken at 9pm 3 large whiskys before bed at 11pm Dinner at 7pm. Mince & potatoes and rice pudding Achy and restless Simvastatin
Paracetamol

Keypoint: Scott fills in his sleep diary.

Scene 4:

Scott’s Sleep Diary

Date: 07/03/15 Bedtime: 11pm Wake time: 3am Duration of sleep: 4 hours
Number of times awake at night: 2 Quality of sleep: Disturbed
Caffeine intake and time taken Alcohol intake and time taken Food/drink intake and time taken How are you feeling? Medications
4 mugs of coffee and 2 cups of tea throughout the day. Last taken at 9pm 3 large whiskys before bed at 11pm Dinner at 7pm. Mince & potatoes and rice pudding Achy and restless Simvastatin
Paracetamol
Reduce caffeine intake, especially later in the day Reduce alcohol intake before bedtime Try taking dinner earlier especially if it is a big meal Review medication for pain

Keypoint: Scott and his GP review his diary together and identify ways to improve his sleep.

Scene 5:
Scott is in bed sleeping, he looks rested. The clock shows 3am.
Keypoint: Scott tries his GP’s suggestions and is getting a better night sleep.

If you would like to try a Sleep Diary like Scott you can:

Download the Patient.co.uk Sleep Diary [.pdf, 326 KB]
Patient.co.uk logo Used with permission from Patient.co.uk available at, http://www.patient.co.uk/health/sleep-diary (c) © 2015, Egton Medical Information Systems Limited. All Rights Reserved

Something to try

If you like using your smartphone, there are many apps available. You can explore this and see what works for you.

More information

How do I get involved?

Now that you are considering joining an organised activity, sports club or exercise programme, here are some questions which you may find useful to ask and write down the answers.

How do I find out more?

  • Find contact details
  • Telephone or email to find out more details about the activity
  • If there is a website, use it to find information on the activity
  • Speak to somebody who already goes
  • Go along to visit if possible
  • Look at GP notice board
  • If you are not confident talking take someone with you to help

Is it appropriate for me?

  • Fitness class: Does the fitness instructor have experience working with people who have had a stroke?
  • What size is the class?
  • Do people with stroke or other conditions attend?
  • Are you required to check with your GP before attending?
  • Walking group: what distances do they do?
  • Do the walks include steep hills?
  • Are there places to rest?
  • Sport: What level do the members play at?
  • Is there a way of adapting the sport of required?
  • Is there a facility for playing for fun

How do I get there?

How far is it from your home?
Can you walk there?
Do you need to take bus?
Is there a direct bus route?
Is the stop outside the venue or nearby?
Do you need a buddy?
Do you have a taxi card/ use dial a bus?
Have you a wheelchair?
Is the venue wheelchair accessible?
Is the venue set up for wheelchair users- toilets etc.
Consider the internal environment-steps rails etc.

I’m going to do it!

Schedule a day and time to go.
Check start and finish times
Check access if the activity is in a building
Check access of toilet facilities
Plan how you are going to get there
Go along early to get settled
Take refreshments in case none available on site. ( Water)
Arrange to go along with a family member or friend

 

Something to try

Why don’t you print these questions and have them handy when looking into leisure activities?

More information

Living it up