I am 43. A massive stroke nine years ago has left me over­weight with poor co-​ordination and bal­ance, and emo­tional stress. I have tried exer­cise classes without suc­cess: the only exer­cise I do is walk the dog. I really want someone who can guide and sup­port me back to fit­ness.

Living with the long-​term effects of a health cata­strophe such as stroke turns every day into a chal­lenge. The kind of dam­age that stroke can do to the brain leaves people with a very wide range of dif­fi­culties to tackle – not just phys­ical, but also affect­ing for instance sight, per­cep­tion, touch and emo­tional responses.

But it is import­ant that you make the effort to exer­cise: phys­ical activ­ity is one of the best ways for stroke sur­viv­ors to com­bat their increased risk of hav­ing a second stroke, dia­betes or heart dis­ease.

To pro­tect your heart and blood ves­sels, the best exer­cise is mod­er­ate aer­obic activ­ity such as brisk walk­ing, cyc­ling or swim­ming. What’s really import­ant is that you do five “car­dio” ses­sions a week, at 30 minutes a time. Which means build­ing it into your daily life­style.

Poor co-​ordination and bal­ance are very com­mon after stroke – and put you at increased risk of fall­ing over. Specific bal­ance train­ing may help. And you should aim to stay strong – low-​level weight train­ing is recom­men­ded. If you are able to get into an exer­cise routine with all these ele­ments, you will also find it much easier to lose the extra weight.

But how to get motiv­ated? The answer depends on your per­son­al­ity, pref­er­ences and means. If you can afford it, you would prob­ably bene­fit greatly from employ­ing a per­sonal fit­ness trainer. This is a big fin­an­cial com­mit­ment as it might take two ses­sions a week for three months until you feel you are on the right track and enjoy­ing your new activ­ity habit.

If you do opt for a per­sonal trainer, check their qual­i­fic­a­tions care­fully: A REPS Level 3 cer­ti­fic­ate is essen­tial, plus an addi­tional qual­i­fic­a­tion to teach people with major con­di­tions (eg: gym for dis­abled people or GP Referral).

Alternatively ask your GP to recom­mend you for a local exer­cise refer­ral scheme. This would also provide expert advice and sup­port at a local gym for those first dif­fi­cult weeks.

There are other options though,. How about find­ing a “buddy” or workout part­ner who can encour­age you and keep your resolve strong? This doesn’t need to be an expert – you would do your learn­ing together, which can also be fun.

Have a look at Different Strokes, a national sup­port group for younger stroke sur­viv­ors. They have a net­work of local groups. Sportability is a char­ity that offers sup­por­ted sports oppor­tun­it­ies in some unusual and adven­tur­ous activ­it­ies such as diving, canoe­ing and abseil­ing – this is one way you could dis­cover a fant­astic new hobby while you are get­ting fit­ter. PHAB is another char­ity with sup­por­ted activ­it­ies and local clubs, so again you may find both a per­son and a pas­sion that will set you on the road to fit­ness.