Physical Therapy Management for Stroke Patients with Type 2 Diabetes

Comprehensive Exercise Program Components

The American Heart Association recommends that stroke patients with type 2 diabetes engage in aerobic activities for a minimum of 150 minutes per week, spread over at least 3 days with no more than 2 consecutive days without exercise 1, 2
The American College of Sports Medicine suggests that intensity should be moderate (40-70% heart rate reserve or 50-80% maximal heart rate), with a rating of perceived exertion of 11-14 on the 6-20 scale 1
The American Diabetes Association recommends that activities should include those that use large muscle groups, such as walking, cycling, or seated stepper exercises 1, 3
For patients with limited mobility, the American Diabetes Association considers non-weight-bearing activities if peripheral neuropathy or foot problems are present 4

The American Diabetes Association recommends that before initiating moderate-to-high intensity exercise, consider a graded exercise test for patients with additional risk factors for coronary artery disease 4
The American Heart Association suggests monitoring for signs of peripheral arterial disease, which may affect exercise tolerance and modality selection 4
The American Diabetes Association recommends monitoring for hypoglycemia during exercise sessions, especially for patients taking insulin or insulin secretagogues 5, 7

The American Heart Association recommends assessing familial support early in the rehabilitation process 1
The American Diabetes Association suggests ensuring proper footwear and daily foot examination for patients with peripheral neuropathy 5
The American College of Cardiology recommends modifying exercise for patients with proliferative diabetic retinopathy to avoid activities that increase intraocular pressure 4
The American Stroke Association recommends incorporating exercises that enhance balance and reduce fall risk 8