From the Guidelines
Patients who have experienced a cerebrovascular accident (CVA) or stroke may be cleared for flying and snorkeling activities after a thorough medical evaluation, provided they have achieved stable blood pressure control, typically defined as a systolic blood pressure less than 140 mmHg, and are not experiencing any residual neurological deficits 1.
Key Considerations
- For patients on anticoagulation therapy, such as warfarin (target INR 2.0-3.0) or aspirin (81-325 mg daily), flying and snorkeling may be permitted after a minimum of 3 months post-stroke, assuming no evidence of atrial fibrillation or other cardiac complications 1.
- Patients with a history of stroke should undergo a comprehensive medical assessment, including a neurological examination and imaging studies, such as MRI or CT scans, to rule out any underlying conditions that may pose a risk during these activities 1.
Safety Precautions
- Medical Clearance: Patients should obtain medical clearance from their healthcare provider before engaging in flying and snorkeling activities, especially if they have any underlying medical conditions or are taking anticoagulation therapy 1.
- Exercise Recommendations: Patients should follow exercise recommendations for stroke survivors, including regular aerobic exercise, resistance training, and flexibility exercises to improve cardiovascular fitness and reduce the risk of recurrent cardiovascular events 1.
- Monitoring: Patients should be monitored for any signs of cardiovascular complications, such as chest pain, shortness of breath, or dizziness, during and after flying and snorkeling activities 1.
From the Research
Safety Considerations for Air Travel and Snorkeling after a Cerebrovascular Accident (CVA) or Stroke
There are no direct research papers to assist in answering this question. However, some general information about post-stroke care and management can be found:
- Post-stroke patients should undergo a formal assessment of rehabilitation needs before hospital discharge 2
- Rehabilitation services aim to improve functional status, and types of rehabilitation include inpatient, subacute, and home health care 2
- Primary care of patients after stroke focuses on secondary stroke prevention, including antiplatelet therapy, hypertension and hyperlipidemia management, diet, and glycemic control 2
- Exercise has both positive physical and psychosocial effects for post-stroke patients, and various types of exercise training (e.g., aerobic, strength, flexibility, neuromuscular, and traditional Chinese exercise) are recommended 3
- Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack provide comprehensive and timely evidence-based recommendations on the prevention of future stroke among survivors of ischemic stroke or transient ischemic attack 4
Risk Factors and Complications
Some studies have identified risk factors and complications associated with post-stroke care:
- Aerobic training may be associated with a higher incidence rate of serious adverse events in patients with pre-existing diabetes mellitus and atrial fibrillation 5
- Early anticoagulation with apixaban may not compromise patient safety in patients with atrial fibrillation and stroke or transient ischemic attack 6
- Post-stroke patients may experience sequelae such as fatigue, depression, contracture and spasticity, hemiplegic shoulder pain, and central post-stroke pain, which should be addressed in follow-up care 2