Self-Managed Exercise in Chronic Stroke

Inclusion criteria

• -diagnosis of stroke > six months < 10 years since stroke onset,
• > 18 years; <90 of age,
• Montreal Cognitive Assessment - BLIND score > 19,
• able to stand from chair and remain standing independently,
• able to walk 20 feet without physical assistance,
• no other neurological diagnosis,
• no history of intermittent claudication,
• no angina at rest or with minimal exertion,
• no history of chronic obstructive pulmonary disease,
• not currently receiving physical rehabilitation services,
• ability to express pain, fatigue or the need for assistance,
• ability to follow a three-step command or mimic exercises
• approval from primary care physician to participate

Exclusion criteria

• a neurologic condition other than stroke, i.e. Parkinson's Disease, multiple sclerosis,
• severe, functional limiting arthritis,
• orthopedic condition that limits mobility,
• severe weight-bearing pain,
• current participation in other physical rehabilitation services or exercise programs,
• Serious cardiac conditions (hospitalization for myocardial infarction or heart surgery within the past year, history of congestive heart failure, documented serious and unstable cardiac arrhythmias, hypertrophic cardiomyopathy, severe aortic stenosis, angina or dyspnea at rest or during activities of daily living). Anyone meeting New York Heart Association criteria for Class 3 or Class 4 heart disease will be excluded,
• Severe hypertension: with systolic > 200 mmHg and diastolic > 110 mmHg at rest, that cannot be medically controlled into the resting range of 180/100 mmHg,
• use of supplemental oxygen at baseline,
• severe obstructive pulmonary disease (Classification of Global Initiative for Chronic Obstructive Lung Disease (GOLD) 3 or higher, indicating FEV1<50% predicted),
• treatment for pneumonia or lower respiratory infection within the past month,
• able to run one-quarter mile without stopping;
• women who are pregnant