People who engaged in light to moderate physical activity before their stroke were twice as likely to have a mild stroke

People who take part in light to moderate physical activity, such as walking at least four hours or swimming two to three hours a week, may have less severe strokes than people who do no physical activity, a new study has suggested.

“Stroke is a major cause of serious disability, so finding ways to prevent stroke or reduce the disability caused by stroke are important,” said the author of the Dr Katharina S. Sunnerhagen, MD, PhD, of the University of Gothenburg in Sweden.

“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.”

For the study, researchers looked at two Swedish stroke registries and identified 925 people with an average age of 73 who had a stroke. The registries included data on stroke severity based on symptoms such as eye, arm and facial movements, level of consciousness and language skills. Of study participants, 80 per cent had a mild stroke.

Participants were asked after the stroke how much they moved or exercised before their stroke. Questions about duration and intensity of exercise were used to determine the average amount of physical activity. Relatives were asked to confirm exercise levels when needed.

Light physical activity was defined as walking at least four hours a week. Moderate physical activity was defined as more intense exercise such as swimming, brisk walking, or running two to three hours a week. Of study participants, 52 per cent said they were physically inactive before having their stroke.

It is important to note that participants reporting on their own physical activity after having a stroke is a limitation of the study. It is possible that memory may be affected by a stroke, and more so in people with more severe stroke, the researchers noted.

According to the findings, people who engaged 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 compared to people who were physically inactive. Of 481 people who were physically inactive, 354 had mild stroke, or 73 per cent. Of 384 who engaged in light physical activity, 330 or 85 per cent had a mild stroke. Of 59 people who engaged in moderate physical activity, 53 or 89 per cent had a mild stroke. Researchers found that light and moderate physical activity were equally beneficial.

“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,” said Dr 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.”

Dr Sunnerhagen also noted that the difference in physical activity did not account for a large amount of the difference in stroke severity. When combined with younger age, greater physical activity accounted for only 6.8 per cent of the difference between the two groups.

She added that the study does not prove that physical activity reduces stroke severity; it only shows an association.

Commenting on this study Professor Joe Harbison, former National Clinical Lead for Stroke in Ireland and Associate Professor, Professor of Gerontology at TCD said it provided more data on the benefits of physical exercise to reduce cardiovascular risk.

“It actually has a benefit independent of weight loss etc. and may be related to better blood pressure and blood glucose control. It also influences mood. This is a registry study i.e. looking retrospectively at data, although it does contain very high numbers. We need to see more on prescribed exercise and social prescribing and more formal studies on same (how much, when etc). Doctors are great with prescribing aspirin, what about prescribing a gym, or a walking club?” Prof Harbison said.

This study was published in the September 19, 2018, online issue of Neurology, the medical journal of the American Academy of Neurology.