Pre-stroke physical activity and admission stroke severity: A systematic review

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• Admission stroke severity is a key predictor of patient outcomes.
• Pre-stroke physical activity is linked to stroke prevention and potentially reduced stroke severity.
• Understanding this association can inform post-stroke care strategies.

Purpose of the Study:

• To systematically review existing evidence on the relationship between pre-stroke physical activity and stroke severity at admission.
• To provide recommendations for future research in this area.

Main Methods:

• A comprehensive search of multiple databases (MEDLINE, Embase, Emcare, CENTRAL) and gray literature was conducted.
• Seven observational studies involving 41,800 stroke survivors were included after screening over 8,000 references.
• Pre-stroke physical activity was assessed via self-report questionnaires, and stroke severity by the National Institute of Health Stroke Scale.

Main Results:

• Three studies found an association between pre-stroke physical activity and milder stroke severity; one study found no association.
• Five studies indicated that higher duration, intensity, or amount of pre-stroke activity correlated with milder stroke severity.
• Potential benefits include reduced risk factors, distal occlusions, smaller infarcts, and faster treatment.

Conclusions:

• Pre-stroke physical activity appears to be associated with reduced stroke severity upon admission.
• The observational nature of the studies and risk of bias limit definitive causal conclusions.
• Further research, particularly randomized controlled trials, is needed to confirm causality.