Fitness instructors train to better assist stroke survivors

After suffering a stroke in 2017, tasks such as climbing a flight of stairs took Maya Seah hours to complete.

The haemorrhagic stroke – or stroke with bleeding in the brain – has caused brain fog, muscle weakness on the right side of her body and affected her ability to communicate.

But Seah, who used to jog and practise yoga before her stroke, has been able to get active recently.

In 2023, she picked up dragon boating and about a month ago, she started going to the gym, with these activities helping in her recovery process.

The 44-year-old was among several stroke survivors who shared their experiences using ActiveSG gyms and swimming pools as part of a pilot training programme launched by the Singapore National Stroke Association (SNSA) and the Singapore Institute of Technology in October.

Aligned with the Disability Sports Masterplan 2024, this programme was set up to create a more inclusive environment in those ActiveSG facilities by equipping fitness professionals with the skills to better assist stroke survivors and people with disabilities.

Surveys with stroke survivors and exercise professionals over the years have found that the former wanted to be fit while the latter wanted to learn more about how to assist people with disabilities in the gym, said Associate Professor Shamala Thilarajah, president of SNSA.

“The next part of it is then building the ecosystem and infrastructure that allows that communication to happen between hospitals, rehabilitation venues and gyms,” added Prof Thilarajah, a senior principal physiotherapist at the Singapore General Hospital.

The surveys also found that stroke survivors wanted assistance as they encountered difficulty adjusting equipment height or sliding a chair forward while maintaining their balance because of a weaker arm or leg.

“That kind of help was available in some gyms, but not every gym, so we wanted to ensure there was help everywhere and people were aware and trained,” said Prof Thilarajah.

The workshops, held in October and November, were a collaboration among professionals from various sectors.

They include fitness instructors from Sport Singapore, physiotherapists from SGH, Tan Tock Seng Hospital, National University Hospital, Changi General Hospital, the Singapore Physiotherapy Association, Stroke Support Station and doctors from Exercise is Medicine Singapore, a movement to make exercise part of disease prevention and treatment.

They were trained in specific techniques for communication, safety considerations and how to adapt exercises for individuals with varying abilities. There were also hands-on sessions for them to practise assisting stroke survivors.

Caregivers such as Seah’s husband Melvin Ye feel that such programmes help to ease their worries.

The 45-year-old, who works in operations, added: “She still needs to go somewhere to keep active, but I’m worried about who is there to help her.

“If I know there is this equipment (and support), it may be easier for her to use it.”

Exercising has been enjoyable for Seah, but she has had mixed interactions with other gym goers. Some are helpful while others have been impatient as she requires more time than most to complete her sets.

She recalled one unpleasant experience when someone glared at her and expressed her frustration by constantly looking at her watch.

Seah said: “I try to ignore (people like that)... There are mostly nicer people, some of them are students, some are older people, they will offer assistance.”

Catherine Lee, who in 2020 suffered an ischaemic stroke – which is caused by reduced blood flow to a part of the brain due to a blood clot in an artery – believes that programmes like this encourage stroke survivors to keep active.

The 65-year-old, whose left arm is functioning at about 70 per cent with weak grip in her fingers, stuck to using a treadmill and equipment such as the Hur machine – which uses air pressure instead of dead weights and reduces the risk of injuries.

“We have to constantly be on the move and exercise,” said the marine sales manager, who needed a wheelchair and walking stick in the months after her stroke.

“I realised that some days when I was down with flu and Covid, I couldn’t exercise for almost two weeks because I was very tired, I could feel everything stiffen up.”

 

Through the programme, ActiveSG senior fitness instructor Victor Ng has learnt how to provide better assistance to stroke survivors in the gym.

He remembers being unsure of how to help one such gym goer whose speech was slurred, but now knows to use gestures and ask simple questions that require only a “yes” or “no” answer.

Other useful techniques the 51-year-old has learnt include knowing how to release a clenched fist caused by spasticity and, in some cases, muscle contractures.

He said: “As fitness instructors, we are quite unsure of how to engage these people, but when I came for this course, I learnt a lot of different ways that we can do so.”