Pre-stroke physical activity in relation to post-stroke outcomes - linked to the International Classification of Functioning, Disability and Health (ICF): A scoping review.

All included studies were rated moderate to critical risk of bias, mainly because of missing data, excluded cases and inadequate adjustment for confounding factors. Pre-stroke activity was self-reported in every study, and all but five studies collected it retrospectively, so recall and selection bias are likely. No study used objective measurements of pre-stroke activity, and several studies did not adequately report intensity, duration and frequency. All studies except one reported analyses with a majority of ischaemic stroke cases, so the findings cannot be extended to haemorrhagic stroke. The scoping review included studies despite high risk of bias and did not provide a single answer to a specific research question. The review did not account for confounding factors, treatment groups and interventions needed to interpret the strength of associations.

Do not conclude that pre-stroke activity causes better stroke recovery. The included studies were mostly observational, used self-reported activity, and had moderate to critical risk of bias, so causal inference is not possible.