The Impact of Physical Activity Before and After Stroke on Stroke Risk and Recovery: a Narrative Review

Kramer, Sharon; Hung, Stanley; Brodtmann, Amy

doi:10.1007/s11910-019-0949-4

Cited by 80 publications

(64 citation statements)

References 91 publications

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“…Daily physical activity was found to be independently associated with a better physical component of quality of life in stroke patients, in a previous study [ 46 ]. Stroke patients spent more time on sedentary behaviors which further affect physical function [ 47 , 48 , 49 ] and recovery after stroke [ 50 ]. The prevalence of physical inactivity was increased during the COVID-19 pandemic which further created a huge burden of cardiovascular disease [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Nguyen

Binh

et al. 2021

Nutrients

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Background: Comorbidity is common and causes poor stroke outcomes. We aimed to examine the modifying impacts of physical activity (PA) and diet quality on the association between comorbidity and disability in stroke patients. Methods: A cross-sectional study was conducted on 951 stable stroke patients in Vietnam from December 2019 to December 2020. The survey questionnaires were administered to assess patients’ characteristics, clinical parameters (e.g., Charlson Comorbidity Index items), health-related behaviors (e.g., PA using the International Physical Activity Questionnaire- short version), health literacy, diet quality (using the Dietary Approaches to Stop Hypertension Quality (DASH-Q) questionnaire), and disability (using the World Health Organization Disability Assessment Schedule II (WHODAS II)). Linear regression models were used to analyze the associations and interactions. Results: The proportion of comorbidity was 49.9% (475/951). The scores of DASH-Q and WHODAS II were 29.2 ± 11.8, 32.3 ± 13.5, respectively. Patients with comorbidity had a higher score of disability (regression coefficient, B, 8.24; 95% confidence interval, 95%CI, 6.66, 9.83; p < 0.001) as compared with those without comorbidity. Patients with comorbidity and higher tertiles of PA (B, −4.65 to −5.48; p < 0.05), and a higher DASH-Q score (B, −0.32; p < 0.001) had a lower disability score, as compared with those without comorbidity and the lowest tertile of PA, and the lowest score of DASH-Q, respectively. Conclusions: Physical activity and diet quality significantly modified the negative impact of comorbidity on disability in stroke patients. Strategic approaches are required to promote physical activity and healthy diet which further improve stroke rehabilitation outcomes.

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Section: Discussionmentioning

confidence: 99%

Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Nguyen

Binh

et al. 2021

Nutrients

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“…Clinical observational studies showed a positive correlation between pre-stroke exercise and better stroke outcomes. 25 Prestroke exercise was associated with reduced stroke injury and improved functional outcomes. 25 This was indicated by a significant reduction in the National Institutes of Health Stroke Scale (NIHSS) scores in the pre-stroke exercise patients groups.…”

Section: Physical Exercise Reduces the Severity Of Stroke Injury And Improves Functional Outcomesmentioning

confidence: 99%

Mechanisms of Preconditioning Exercise-Induced Neurovascular Protection in Stroke

et al. 2021

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Ischemic stroke is a leading cause of death and disability. Tissue plasminogen activator is the only U.S. Food and Drug Administration approved thrombolytic therapy for ischemic stroke patients till date. However, its use is limited due to increased risk of bleeding and narrow therapeutic window. Most of the preclinically tested pharmacological agents failed to be translated to the clinic. This drives the need for alternative therapeutic approaches that not only provide enhanced neuroprotection, but also reduce the risk of stroke. Physical exercise is a sort of preconditioning that provides the body with brief ischemic episodes that can protect the body from subsequent severe ischemic attacks like stroke. Physical exercise is known to improve cardiovascular health. However, its role in providing neuroprotection in stroke is not clear. Clinical observational studies showed a correlation between regular physical exercise and reduced risk and severity of ischemic stroke and better outcomes after stroke. However, the underlying mechanisms through which prestroke exercise can reduce the stroke injury and improve the outcomes are not completely understood. The purpose of this review is to: demonstrate the impact of exercise on stroke outcomes and show the potential role of exercise in stroke prevention and recovery; uncover the underlying mechanisms through which exercise reduces the neurovascular injury and improves stroke outcomes aiming to develop novel therapeutic approaches.

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“…A recent review ( 16 ) concluded that individuals after stroke were less active than individuals with other chronic conditions, such as diabetes and chronic obstructive pulmonary disease (COPD); and that they took half the amount of steps (4,078 vs. 8,338 steps/day) and expended half the daily energy on physical activity (1257.3 vs. 2108.9 kcal/day), as compared with healthy individuals. This is concerning because physical activity, especially MVPA, plays a crucial role for stroke recovery to mitigate residual effects of stroke and to manage future cardiovascular risk ( 14 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Active With Whom? Examining the Social Context of Physical Activity in Individuals After Stroke and Their Partners

Pauly

Ashe

Murphy

et al. 2021

Front. Public Health

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Engaging in regular moderate-to-vigorous intensity physical activity (MVPA) is crucial to reduce future health risk for individuals living with the effects of a stroke and their partners. Although numerous studies point to the importance of social factors in physical activity engagement, little is known about with whom individuals after stroke and their partners engage in physical activity with and whether different physical activity companions are uniquely associated with MVPA. Eighty-nine community-dwelling individuals after stroke (Mage = 68.64, SD = 10.44; 74% male) and 83 partners (Mage = 66.04, SD = 9.91; 24% male) completed 14 consecutive days of daily life assessments that included wearing physical activity monitors (accelerometers) and self-reporting physical activity companions (n = 1,961 days). Results show that average levels of MVPA were correlated between partners (r = 0.38), as were day-to-day MVPA fluctuations (r = 0.34). Importantly, for individuals after stroke, being active with their partner, but not with any other physical activity companion, was linked with elevated daily MVPA. In contrast, for partners of individuals after stroke, engaging in physical activity with a variety of different companions (partner, other family member, friend, colleague) was each associated with higher MVPA in daily life. For both individuals after stroke and their partners being active by oneself (without a companion) on a given day was not associated with elevated MVPA. Findings suggest that interventions that promote physical activity engagement should consider the role of meaningful others, with the partner being particularly key for individuals living with chronic health conditions.

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The Impact of Physical Activity Before and After Stroke on Stroke Risk and Recovery: a Narrative Review

Cited by 80 publications

References 91 publications

Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Physical Activity and Diet Quality Modify the Association between Comorbidity and Disability among Stroke Patients

Mechanisms of Preconditioning Exercise-Induced Neurovascular Protection in Stroke

Active With Whom? Examining the Social Context of Physical Activity in Individuals After Stroke and Their Partners

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