Association between pre-stroke physical activity and mobility and walking ability in the early subacute phase: A registry-based study.
Malin Reinholdsson, Anna Grimby-Ekman, Hanna C Persson
PMID 34652453WHAT IT FOUND
Pre-stroke physical activity was not significantly associated with better mobility or walking recovery in the early subacute phase.
Both active and inactive patients improved similarly during stroke unit care. Do not expect higher pre-stroke fitness to guarantee faster functional recovery.
Key findings
01There was no significant difference in the improvement of mobility or walking ability over time between patients who were physically active before their stroke and those who were inactive.
02Pre-stroke physical activity was not associated with self-perceived upper extremity function at any time point.
03In the total sample including patients who died during care, there were significant differences in mobility and walking ability between active and inactive groups, but these results were not seen in the analysis of stroke survivors alone.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
A high proportion of patients with severe strokes were excluded because pre-stroke physical activity was not routinely assessed for them, limiting generalizability to more severe cases. Pre-stroke physical activity was self-reported retrospectively, which introduces recall bias. Stroke severity (NIHSS) was missing for 21% of patients, so models could not be adjusted for this major confounder. The physical activity scale used (SGPALS) focuses on leisure-time activity and may not reflect work-related or arm-specific activities. Outcomes were dichotomized (e.g., independent vs. not independent), losing information about the degree of impairment.
Declared interests
The study was based on data from a tax-funded healthcare database (Väststroke registry). No specific financial conflicts of interest or funding sources for the analysis were declared in the provided text.
The easy way to misread this
Do not conclude that pre-stroke physical activity has no value. This study only examined its association with early functional recovery outcomes in a specific stroke unit population, mostly with mild strokes. It does not address other benefits of pre-stroke fitness, such as survival, prevention, or long-term chronic recovery.