Abstract
Background and Purpose: Emerging evidence suggests that stroke recovery is influenced by pre-stroke physical activity (PA). The purpose of this study was to examine whether prospectively collected pre-stroke PA levels were associated with functioning one year post-stroke in survivors of a first stroke. Methods: PA was assessed during baseline interviews of participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) observational study. Participants who experienced a first-ever stroke event during follow up were enrolled in an ancillary study. Approximately 12 months following stroke incidence, survivors and their informants were interviewed by telephone, and an in-home assessment of functional ability was conducted (n = 203). The association between pre-stroke PA and post-stroke function was assessed. Results: Participants reported baseline PA as either no vigorous PA (n = 65), or PA once or more per week (n = 138). Individuals who exercised at least once per week had significantly greater function at one year following stroke as assessed with the NIHSS, the Barthel Index and the Stroke Impact Scale physical domain score. In the multivariate model, race, education, sex, age, length of hospital stay and discharge destination were associated with functioning and attenuated this relationship. However, the significant association between pre-stroke PA and the NIHSS remained (p = 0.003). Conclusions: Self-reported PA prior to stroke was associated with significantly lower NIHSS scores one year after stroke. Other physical function measures were attenuated by factors such as female sex and African American race which were strongly related to poorer function.
Published Version
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