Hemorrhagic Stroke Rehab suggestions

I am not looking for medical advice, but I am looking for zwift advice. on July 18, 2020 while about 25 miles into a planned 50 mile solo outdoor ride I suffered a hemorrhage at my Brain Stem. After a scary several days / weeks I have managed to regain most of my motor functions. Balance is returning with improvement by the day. My two eyes are not in sync with each other but I am hopeful that as the nerves repair, and or other nerves take over my sight will return to normal as well.
My question for this group is: Can zwift be used as a tool for rehab? If so what would be a logical approach? My initial thoughts are to experiment with ERG mode while monitoring my heart rate. Taking it easy at first and working my way up to pre-stroke conditioning and beyond.
My neuro-surgeon and rehab team will be consulted every step of the way, but experienced zwifter advice will be appreciated.
Thank You

Erg mode makes sense I would think, but you can also turn off trainer difficulty to make all roads flat roads.

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Zwift is like any other cardio exercise that can elevate HR and BP to some extent. I would use just set my trainer difficulty to 0% and free ride while keeping you HR where you want it. ERG mode I believe only works with structured workouts.
I did use Zwift to rehab after a brain injury myself and found Zwift much better than walking to control my HR. However, I could only do light walking for 3 months right after my surgery. Depending on the cause of your hemorrhage I would work with your doctors on what kind of exercise they recommend and why. It helps to find a specialist who understands athletes and how we can work with HR zones.

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I think so, but you can create your own workout that’s, say, an hour at 80W or whatever.



I think you’ve already read this article recently, but for others, here 'tis:

And that’s not remotely the end of the story.

Thanks to everyone that replied. I have been cleared for the trainer and am still not exactly sure how I will set up my personalized training regimen. Heart Rate will be my focus, and my neuro doc requested that I use a cuff to monitor BP 4 or 5 times per hour.
Psyched to clip in and spin after nearly a month off the bike. Hoping that I can take it slow and be in tip top condition come spring 2021!

Good luck Tim!

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Hi Bob,
I was able to go to “custom” workout and setup a 60 minute workout at a specific wattage. For me I opted for 1/2 of my pre-stroke FTP.
I did not see an option for setting my trainer difficulty to 0%. I looked in the settings area but did not see anything that allowed me to change the difficulty %.
On second thought, I was merely playing with the Zwift software in training mode and was not linked/connected to any of my sensors, or smart trainer at the time. Perhaps that is the reason.
I am going through a learning curve regarding zwift, but I’ll enjoy the challenge and new knowledge gained.

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Look and ye shall find! Had to replace “.” with “-dot-” as links are not welcome here.


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Great news Tim and great progress. Depending on what caused your hemorrhage will allow you to tailor your workouts. Wattage and HR are certainly related but if HR is what you need to closely watch then just keep an eye on it and don’t allow it to run up on you. While your custom program will help manage your wattage it will not limit your HR. Now, if HR is not an issue given your situation then that’s one less worry. I know you mentioned that one of your docs said keep an eye on BP and that is certainly something you want to do because even people who do not have high BP can have an elevated exercise BP or hypertensive exercise BP. If an elevated BP is not good for your recovery than you certainly want to monitor that as you Zwift. Also, you may be on new meds so take your new workouts a bit slowly at first just to see how your body is going to respond. Your on the right track and I think Zwift is going to a great tool for you to get yourself back to 100%!! RIDE ON

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When I was recovering I used a heart rate watch that vibrates my wrist any time I was tempted into overdoing it.

As soon as the watch vibrated I took a 5 min rest / cool down. Sometimes even called it a day at that.

Not sure if the heart rate monitors that go round your chest (Tickr etc) have a vibrate function but I found it very useful to keep me from the temptation of overdoing it.

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Good suggestion Ewan. I can set my smart watch to send a vibration alert when i approach a target MAX. Currently I am doing easy 60 minute workout spins in ERG mode, keeping an eye on BPM and stopping to take my Blood Pressure every 15 minutes.
Just trying to keep my legs moving without bursting another blood vessel. I am only a little over three weeks out from the hemorrhage and still in healing mode, and I don’t care to push this rehab to a level that my body might not appreciate. My watch will be set to buzz mode for sure!

One thing I learned the hard way is not overdoing it (pre-HR watch) so listen to your body and take it easy.

I’m no medic so I can’t advise what to do, when or even if it’s too soon yet but defo resist temptation to gun it or push past your limit - there’s plenty chance in months/years to come to up the pace. Stay safe :slightly_smiling_face:

From the info I have received from my medical team the trick will be to find a regimen where I am not pushing too hard or too easy. I think that it is safe to say that as cyclists, the majority of us are masochists of a sort. We love to push our bodies to the limit, knowing that that last workout will make the next hill, race, or group ride that much more enjoyable.
It is a challenge for me spinning for an hour whilst not breaking a sweat. But, an hour of easy spin beats an hour on the couch, every day of the week. I figure that if it takes 1, 2, 6 months or even 1 or 2 years I am ready for the challenge, the important thing is to move forward and not do anything that will set me back.
Ride On! See you in watopia!