Physical activity is an important factor for primary and secondary stroke prevention. The process of stroke rehabilitation includes early and late physical activity and exercise, which prevents further stoke and improve patients' quality of life. MY WAY project, an ERASMUS+ SPORT program, is aimed at analyzing and developing or transferring best innovative practices related to physical activity and exercise enhancing health in poststroke patients. The aim of the study was to identify, analyze, and present the good practices and strategies to encourage participation in sport and physical activity and engage and motivate chronic stroke patients to perform physical activity changing their lifestyle and to maintain a high adherence to long-term exercise-based rehabilitation programs. Our results demonstrated that unified European stroke long-term exercise-based rehabilitation guidelines do not exist. It seems that low training frequency with high aerobic exercise intensity may be optimal for improved physical performance and quality of life in combination with a high adherence. It is important to optimize the training protocols suitable for each patient. The continuous education and training of the specialized professionals in this field and the presence of adequate structures and cooperation between different healthcare centers are important contributors. The clear objective for each country should be to systematically make the necessary steps to enhance overall exercise-based stroke rehabilitation attendance in the long term. Long-term interventions to support the importance of physical exercise and lifelong exercise-based rehabilitation in chronic stroke patients should be created, what coincides with the goal of the MY WAY project.

CEREBRUM Association of People with Acquired Brain Injuries and their Families Czech Republic

Croatian Stroke Society Croatia

Department of Anatomical Histological Legal and Locomotor Sciences of Sapienza University Italy

Department of Neurology Stroke and Intensive Care Unit Sveti Duh University Hospital Zagreb Croatia

Department of Physical Medicine and Rehabilitation Sveti Duh University Hospital Zagreb Croatia

Dom zdravlja Zagrebačke županije Velika Gorica Croatia

Faculty of Medicine University J J Strossmayer Osijek Croatia

Istituto Europeo per lo Sviluppo Socio Economico Italy

Klaipėda University Lithuania

Laboratory of Sports Medicine Aristotle University of Thessaloniki Greece

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Avan A., Digaleh H., di Napoli M., et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017. BMC Medicine . 2019;17(1):p. 191. doi: 10.1186/s12916-019-1397-3. PubMed DOI PMC

Timmis A., Townsend N., Gale C. P., et al. European Society of Cardiology: cardiovascular disease statistics 2019. European Heart Journal . 2020;41(1):12–85. doi: 10.1093/eurheartj/ehz859. PubMed DOI

Béjot Y., Bailly H., Durier J., Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Presse Médicale . 2016;45(12):e391–e398. doi: 10.1016/j.lpm.2016.10.003. PubMed DOI

Wafa H. A., Wolfe C. D. A., Emmett E., Roth G. A., Johnson C. O., Wang Y. Burden of stroke in Europe. Stroke . 2020;51(8):2418–2427. doi: 10.1161/STROKEAHA.120.029606. PubMed DOI PMC

McHutchison C. A., Cvoro V., Makin S., Chappell F. M., Shuler K., Wardlaw J. M. Functional, cognitive and physical outcomes 3 years after minor lacunar or cortical ischaemic stroke. Journal of Neurology, Neurosurgery & Psychiatry . 2019;90(4):436–443. doi: 10.1136/jnnp-2018-319134. PubMed DOI PMC

ESO (European Stroke Organisation Executive Committee) Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovascular Diseases . 2008;25(5):457–507. doi: 10.1159/000131083. PubMed DOI

GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet . 2017;390:1345–1422. PubMed PMC

SAFE. The burden of stroke in Europe report. 2020. https://strokeeurope.eu .

Stevens E., Emmett E., Wang Y., McKevitt C., Wolfe C. The burden of stroke in Europe . Stroke Alliance for Europe; 2017.

Winstein C. J., Stein J., Arena R., et al. Guidelines for adult stroke rehabilitation and recovery. Stroke . 2016;47:98–169. PubMed

Han P., Zhang W., Kang L., et al. Clinical evidence of exercise benefits for stroke. Advances in Experimental Medicine & Biology . 2017;1000:131–151. doi: 10.1007/978-981-10-4304-8_9. PubMed DOI

Saunders D. H., Sanderson M., Hayes S., et al. Physical fitness training for stroke patients. The Cochrane Database of Systematic Reviews . 2020;3(3, article CD003316) doi: 10.1002/14651858.CD003316.pub7. PubMed DOI PMC

Xing Y., Yang S.-D., Dong F., Wang M.-M., Feng Y.-S., Zhang F. The beneficial role of early exercise training following stroke and possible mechanisms. Life Sciences . 2018;198:32–37. doi: 10.1016/j.lfs.2018.02.018. PubMed DOI

Xing Y., Bai Y. A review of exercise-induced neuroplasticity in ischemic stroke: pathology and mechanisms. Molecular Neurobiology . 2020;57(10):4218–4231. doi: 10.1007/s12035-020-02021-1. PubMed DOI

Norrving B., Barrick J., Davalos A., et al. Action plan for stroke in Europe 2018-2030. European Stroke Journal . 2018;3(4):309–336. doi: 10.1177/2396987318808719. PubMed DOI PMC

Filipović B. Differences in functional recovery and quality of life of patients with stroke between stationary and home rehabilitation, [Ph. D. thesis] Zagreb: University of Zagreb, Faculty of Kinesiology; 2015. https://urn.nsk.hr/urn:nbn:hr:117:447858 .

Orbanić I., Moslavac S., Moslavac A., et al. Rehabilitacija pacijenata s funkcijskim oštećenjem šake pomoću zrcalne vizualne iluzije . Fizikalna i rehabilitacijska medicina; 2017. https://hrcak.srce.hr/234899 .

Konečný P., Tarasová M., Kubíková J., Vernerová M. Robotická rehabilitace spasticity ruky (robotic rehabilitation of the hand spasticity) Rehabilitace a Fyzikální Lékařství . 2017;24:p. 1.

Oktábcová A., Uhlířová J., Čábelková A. The involvement of the Amadeo instrument into a standard therapy in patiens after brain vascular event in the chronic phase: a follow up study (Zapojení přístroje Amadeo do standardní terapie u pacientů u ceévní mozkové příhodě v chronické fázi: follow-up studie) Rehabilitace a Fyzikální Lékařství . 2017;24(1):23–28.

Ploumis A., Papadopoulou S. L., Theodorou S. J., Exarchakos G., Givissis P., Beris A. Cervical isometric exercises improve dysphagia and cervical spine malalignment following stroke with hemiparesis: a randomized controlled trial. European Journal of Physical and Rehabilitation Medicine . 2018;54(6):845–852. doi: 10.23736/S1973-9087.17.04952-8. PubMed DOI

Fotakopoulos G., Kotlia P. The value of exercise rehabilitation program accompanied by experiential music for recovery of cognitive and motor skills in stroke patients. Journal of Stroke and Cerebrovascular Diseases . 2018;27(11):2932–2939. doi: 10.1016/j.jstrokecerebrovasdis.2018.06.025. PubMed DOI

Calugi S., Taricco M., Rucci P., et al. Effectiveness of adaptive physical activity combined with therapeutic patient education in stroke survivors at twelve months: a non-randomized parallel group study. European Journal of Physical and Rehabilitation Medicine . 2016;52(1):72–80. PubMed

Lamberti N., Straudi S., Malagoni A. M., et al. Effects of low-intensity endurance and resistance training on mobility in chronic stroke survivors: a pilot randomized controlled study. European Journal of Physical and Rehabilitation Medicine . 2017;53(2):228–239. doi: 10.23736/S1973-9087.16.04322-7. PubMed DOI

Choi W., Han D., Kim J., Lee S. Whole-body vibration combined with treadmill training improves walking performance in post-stroke patients: a randomized controlled trial. Medical Science Monitor . 2017;23:4918–4925. doi: 10.12659/MSM.904474. PubMed DOI PMC

Pang M. Y. C., Yang L., Ouyang H., Lam F. M. H., Huang M., Jehu D. A. Dual-task exercise reduces cognitive: motor interference in walking and falls after stroke. Stroke . 2018;49(12):2990–2998. doi: 10.1161/STROKEAHA.118.022157. PubMed DOI

Sandberg K., Kleist M., Falk L., Enthoven P. Effects of twice-weekly intense aerobic exercise in early subacute stroke: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation . 2016;97(8):1244–1253. doi: 10.1016/j.apmr.2016.01.030. PubMed DOI

Zhu Z., Cui L., Yin M., et al. Hydrotherapy vs conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial. Clinical Rehabilitation . 2016;30(6):587–593. doi: 10.1177/0269215515593392. PubMed DOI

Haruyama K., Kawakami M., Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients. Neurorehabilitation and Neural Repair . 2017;31(3):240–249. doi: 10.1177/1545968316675431. PubMed DOI

Park H. K., Lee H. J., Lee S. J., Lee W. H. Land-based and aquatic trunk exercise program improve trunk control, balance and activities of daily living ability in stroke: a randomized clinical trial. European Journal of Physical and Rehabilitation Medicine . 2019;55(6):687–694. doi: 10.23736/S1973-9087.18.05369-8. PubMed DOI

Duncan P. W., Sullivan K. J., Behrman A. L., et al. Body-weight-supported treadmill rehabilitation after stroke. New England Journal of Medicine . 2011;364(21):2026–2036. doi: 10.1056/NEJMoa1010790. PubMed DOI PMC

Karasu A. U., Batur E. B., Karataş G. K. Effectiveness of Wii-based rehabilitation in stroke: a randomized controlled study. Journal of Rehabilitation Medicine . 2018;50(5):406–412. doi: 10.2340/16501977-2331. PubMed DOI

Xie G., Rao T., Lin L., et al. Effects of Tai Chi Yunshou exercise on community-based stroke patients: a cluster randomized controlled trial. European Review of Aging & Physical Activity . 2018;15(1) doi: 10.1186/s11556-018-0206-x. PubMed DOI PMC

Aguiar L. T., Nadeau S., Britto R. R., Teixeira-Salmela L. F., Martins J. C., Faria C. D. C. d. M. Effects of aerobic training on physical activity in people with stroke: protocol for a randomized controlled trial. Trials . 2018;19(1):p. 446. doi: 10.1186/s13063-018-2823-0. PubMed DOI PMC

Ehrensberger M., Simpson D., Broderick P., et al. Unilateral strength training and mirror therapy in patients with chronic Stroke. American Journal of Physical Medicine & Rehabilitation . 2019;98(8):657–665. doi: 10.1097/PHM.0000000000001162. PubMed DOI

Ihle-Hansen H., Langhammer B., Lydersen S., Gunnes M., Indredavik B., Askim T. A physical activity intervention to prevent cognitive decline after stroke: secondary results from the Life After Stroke study, an 18-month randomized controlled trial. Journal of Rehabilitation Medicine . 2019;51(9):646–651. doi: 10.2340/16501977-2588. PubMed DOI

Nave A. H., Rackoll T., Grittner U., et al. Physical fitness training in patients with subacute stroke (PHYS-STROKE): multicentre, randomised controlled, endpoint blinded trial. British Medical Journal . 2019;366, article I5l01 doi: 10.1136/bmj.l5101. PubMed DOI PMC

My Way Report. A European collaborative and innovative partnership to promote physical activity after stroke event. Intellectual output 2, Identification of good practices . 2020. 613107-EPP-1-2019-1-IT-SPO-SCP.