The association between pre-stroke physical activity and cerebral collateral circulation in acute ischaemic stroke

To investigate the association between pre-stroke physical activity and cerebral collateral circulation in acute ischaemic stroke survivors.

Using a cross-sectional design, we recruited ischaemic stroke survivors from two hospital acute stroke units and included participants with ICA and MCA M1/M2 segment occlusions. The Physical Activity Scale for the Elderly (PASE) was used to measure physical activity levels during the 7 days prior to stroke onset. Clinically acquired computed tomography perfusion (CTP) imaging was used to assess cerebral collateral circulation using the hypoperfusion intensity ratio (HIR) and visual grading with dynamic computed tomography angiography reconstructed from CTP images. Spearman's correlation coefficient was used to examine the association between the PASE Total Score and HIR. Independent sample t-test was used to estimate the difference in HIR between those who reported engaging in pre-stroke leisure walking and those who did not.

We included 29 participants (mean ± SD = 71.5 ± 12.5 years; 38 % female). No association was observed between the PASE Total Score and HIR. Participants who engaged in leisure walking (mean ± SD = 0.30 ± 0.21) had lower HIR compared to participants who did not (mean ± SD = 0.46 ± 0.14) (estimated mean difference = 0.16, 95 %CI = 0.01 to 0.31, p = 0.04).

This study provides preliminary evidence to suggest that pre-stroke leisure walking may an important activity type associated with cerebral collateral circulation. Larger studies are required to further investigate the relationship between pre-stroke physical activity and collateral circulation.