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Regular exercise before stroke predicts less disability after stroke

BMI does not predict the level of disability after stroke, but those who exercised regularly prior to stroke were more likely to be independent stroke compared with those who were inactive, according to recent findings.

“[Previous] retrospective reports may be inaccurate, and such designs cannot evaluate how functional status changed as a result of stroke, eg, whether physical activity or prestroke BMI modifies the change in functioning associated with stroke onset,” Pamela M. Rist, ScD, from Brigham and Women’s Hospital and Harvard University, and colleagues wrote. “Prior research also could not compare functioning in stroke patients or those who later develop a stroke to functioning in healthy individuals.”

Researchers compared changes in instrumental activities of daily living and activities of daily living in adults who were stroke-free at baseline to determine if physical activity and BMI predict disability trajectories before and after stroke. In this prospective cohort, they used the Health and Retirement Study to follow 18,117 adults without a history of stroke in 1998 for up to 14 years. The investigators used linear regression models to compare the 16,264 adults who remained stroke-free throughout follow up, 1,374 adults who survived stroke and 479 adults who died after stroke and before the next interview wave.

Stroke survivors who were physically inactive at baseline had a lower probability of independence in activities of daily living and instrumental activities of daily living 3 years after stroke compared with those who were physically active: Risk differences were –0.18 for activities of daily living and –0.16 for instrumental activities of daily living. The results showed that a similar difference in the probability of independence was present 3 years before stroke, and the researchers found no evidence that physical activity slowed the rate of decline in independence before or after stroke. The investigators did not find any difference in independence in activities of daily living or instrumental activities of daily living between obese stroke survivors and normal weight or overweight stroke survivors 3 years before or after stroke.

“The lower probability of independence seen among physically inactive individuals... is driven by differences in the probability of independence 3 years before stroke between physically active and physically inactive individuals,” Rist and colleagues wrote. “Future research directions include exploring the association between physical activity intensity and stroke outcomes to help inform public health recommendations and whether changes in physical activity patterns also predict stroke outcomes.” – by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.