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Fitness Might Limit Stroke's Impact

TUESDAY July 14, 2009 -- People who have exercised regularly in the years before a stroke may be harmed less by the attack than "couch potato" types, a new study indicates.

"It's not necessarily high-intensity physical activity," said study senior author Dr. James F. Meschia, a professor of neurology at the Mayo Clinic in Jacksonville, Fla. "It's setting aside time for exercise, 20 minutes to one hour a day, three days a week."

Those among the 673 people in the Ischemic Stroke Genetics Study who had such exercise regimens did better on two different scales measuring the impact of a first stroke, according to a report published online July 13 in the Journal of Neurology, Neurosurgery and Psychiatry.

One of the two scales used was the Barthel Index, a well-established measure of ability to perform 20 daily activities such as the ability to dress oneself and bathe oneself. "It doesn't probe complicated activities, such as driving or keeping track of a checkbook," Meschia said.

Study participants were also measured on the Oxford Handicap Scale. "It's more of a global measurement," Meschia said. "It takes into consideration whether someone has difficulty comprehending speech, whether one couldn't return to work or couldn't enjoy reading."

Return to work was not an issue for most of the people in the study, whose age averaged about 70, Meschia said. But the 50.5 percent of the participants who reported having had regular exercise one to three times a week before their strokes appeared to function better than those who had not exercised, and the 21 percent who reported aerobic physical activity four or more times a week appeared to do even better still.

The study was not large enough to established a direct relationship between the amount of pre-stroke exercise and better functioning afterward, but "there was a trend toward that," Meschia said.

"The straightforward explanation is that if you are physically fit you can compensate better for the deficit cause by the stroke because you have more reserve," he said. "That may not be the whole picture, but it is probably much of it."

But the study results are also still preliminary, the researchers said. "Our findings should be seen as exploratory, requiring confirmation, ideally in a longitudinal study of exercise in an older population," they wrote.

Whatever the effect of prior exercise might be on easing the effects of a stroke, there is evidence that "it leads to a decreased risk of having a stroke to begin with," said Dr. Larry B. Goldstein, director of the Duke Stroke Center.

"There are several studies showing a decreased risk of stroke and of cardiovascular disease in general," Goldstein said. "That is reasonably well-established, even though there have been no randomized trials, just observational studies."

As for exercise after a stroke, "the evidence is still evolving, but it seems that being physically active helps," Goldstein said. "People who exercise seem to do better functionally. Also, it seems to help in secondary prevention. Being physically active helps reduce the risk of a second stroke."

That's important, he said, because "the best way to treat a stroke is not to have it."

More information

Find out how to cut your stroke risk at American Stroke Association .

Posted: July 2009


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