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Dr. Susan Marzolini

Finding the polypill for stroke side-effects

Stroke reaches well beyond the brain. It damages muscles, weakens memory, impedes thinking, causes bone loss and increases the risk of fractures.

The good news is that exercise may be a polypill to treat all of these conditions and help promote stroke recovery.

At Toronto Rehabilitation Institute, exercise physiologist Dr. Susan Marzolini studies the benefits of exercise to repair the brain and restore lost mobility after stroke.

“Exercise has been found to improve brain health and cognition (thinking, decision-making, memory) in people post-stroke and it has been shown to improve mobility,” says Dr. Marzolini, a researcher with the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (CPSR).

Exercise also improves bone health, which is a big issue for people living with stroke. A year after stroke, most people experience a significant decrease in bone density (especially on the affected side of the body) because they are not only walking less and standing less, but using their non-affected limbs to support most of their body weight. The result? Many people suffer broken bones, including hip fractures, and make poor recoveries.

But, sadly, too few stroke recoverers have access to the exercise programs they require to make an optimal recovery.

“Many people are so busy trying to survive that they can’t advocate for themselves,” Dr. Marzolini says. “There’s nowhere for these people to go and they end up with other chronic diseases. Five years after stroke, more people are likely to die of a heart attack than stroke.”

In 2013, Dr. Marzolini was involved in an important research study that revealed stroke patients who participate in a cardiac rehabilitation program for six months make rapid gains in how far and how fast they can walk, the use of weakened limbs and the ability to sit and stand – even years after their strokes.

At the Canadian Stroke Congress, Dr. Marzolini urged expansion of programs across Canada for people living with stroke. Along with other CPSR researchers, she is now studing the barriers to integrating stroke patients into cardiac rehab programs across Canada.

In a new six-month study of 72 stroke survivors, funded by CPSR and the Ontario Stroke Network, Dr. Marzolini and colleagues are comparing the benefits of aerobic exercise alone versus a combination of aerobics and resistance training on cognition and mobility.

“Nobody has done this is in stroke before,” Dr. Marzolini says. The goal is to develop an exercise prescription to guide development of best practice guidelines for recovery.

“We are one step closer to finding the optimal way to improve function, memory, thinking and quality of life after stroke,” she says. “This is one more study that will add to the evidence that this is what they need.”