Sep 21, 2018
Compared to people who don’t exercise much at all, those who
engage in light to moderate physical activity, such as walking at least four
hours a week or swimming two to three hours a week, may have less severe
strokes, based on the findings of a new study.
The results were
published online yesterday in Neurology, the medical journal of the
American Academy of Neurology.
"Stroke is a major cause of serious disability, so finding
ways to prevent stroke or reduce the disability caused by stroke are
important," said study author Katharina S. Sunnerhagen, MD, PhD, of the
University of Gothenburg in Sweden in a press release. "While exercise benefits health in
many ways, our research suggests that even simply getting in a small amount of
physical activity each week may have a big impact later by possibly reducing
the severity of a stroke."
"Results of this study show that pre-stroke physical
activity and younger age are at least partially associated with less
severe stroke after correcting for potential risk factors such as
gender, smoking status, diabetes and being on medications to treat high blood
pressure and lower cholesterol, said Dr. Anand Patel, a
vascular neurologist at Northwell Health's Neuroscience Institute in Manhasset,
New York. “This study also demonstrates the importance and positive impact
of light physical activity such as walking or riding a bicycle for at least 4
hours a week, as this was associated with lower stroke severity as
compared to physical inactivity."
For the retrospective study, the investigators examined 2
Swedish stroke registries and selected 925 people with an average age of 73 who
had a stroke. The registries also provided data on stroke severity that
included information on symptoms that affected eye, arm and facial strength
(and movements), level of consciousness and quality of language. Of those
patients selected for
In order to assess level of physical activity, people who
participated in the study were interviewed after their stroke, and asked to
what degree they engaged in any form of exercise before having their stroke.
Researchers posed questions to better understand the intensity and duration of
exercise in order to measure the average amount of physical activity. The
investigators also interviewed family members and relative to confirm the
degree or extent of exercise when possible.
For the study, light physical activity meant walking at least 4
hours a week. Moderate physical activity was defined as more intense exercise
and included brisk walking, swimming or running 2-3 hours a week. 52% of the
people included in the study stated they were not physically active before
having their stroke.
However, one important limitation of the study
was the fact that participants self-reported their physical activity after
suffering a stroke. Just having a stroke could be a factor affecting memory
pre-stroke activity routine, so supportive data from family members and
relatives would be vital to ensure accuracy, and even more so in the setting or
a severe stroke.
Study findings revealed that people who participated in light to
moderate physical activity before their stroke were twice as likely to have a
mild stroke rather than a moderate or severe stroke when compared to people who
were not physically active. Of 481 people who were not physically active, 73%
(354) had a mild stroke. Of 384 people who participated in light physical
activity, 85% (330) had a mild stroke. Of the 59 study participants who
participated in moderate physical activity, 89% (53) had a mild stroke.
Engaging in either light or moderate physical activity were equally beneficial,
according to the findings.
" There is a growing body of evidence
that physical activity may have a protective effect on the brain and
our research adds to that evidence," explained Sunnerhagen. "Further
research is needed to better understand just how physical activity influences
the severity of a stroke. Finally, physical inactivity should be monitored as a
possible risk factor for severe stroke."
Interestingly, the study also noted that the difference in
physical activity between the physically active groups did not account for a
significant degree of difference in stroke severity. Added to a younger age,
more physical activity accounted for only 6.8 percent of the difference between
the two groups. Other factors such as high blood pressure, diabetes, atrial
fibrillation, elevated cholesterol or triglycerides might also account for
differences between the groups that emerged from the findings.
It’s also important to understand that this study only
established an association that physical activity reduces stroke severity; it
does not indicate a cause and effect relationship.
Exercise and staying active is crucial as we age. Important
modifiable risk factors for stroke include blood pressure, obesity,
cholesterol, treatment of diabetes and atrial fibrillation, an arrhythmia which
if left untreated increases the risk of stroke by at least 15%. It's also vital
to realize that other than atrial fibrillation, these modifiable factors also
increase the risk for coronary artery disease, a major risk factor for heart
attack (myocardial infarction).
The American Heart Association (AHA)
recommends 150 minutes per week of moderate exercise, or 75 minutes per week of
vigorous exercise (or a combination of moderate and vigorous activity) in order
to improve cardiovascular health. 30 minutes a day, 5 times per week would be
ideal, or 25 minutes of vigorous aerobic activity 3 days per week for a total
of 75 minutes.
The study, while limited due to the bias of self-reported data,
still offers sound advice. Engaging in exercise may offer an extra benefit as
we age, reducing the chances of having a debilitating stroke that could leave
us paralyzed or reduce your cognitive abilities.
What's clear from a growing body of medical literature is that
our principal enemy is physical inactivity. We have to fight the urge to sit,
and get up and become more active throughout the day and our lives.
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