Prestroke Physical Activity Matters for Functional Limitations: A Longitudinal Case-Control Study of 12,860 Participants.
Zachary M van Allen, Dan Orsholits, Matthieu P Boisgontier
PMID 39012033WHAT IT FOUND
People who were physically active before their stroke had fewer limitations in daily tasks like dressing and walking than those who were inactive.
This protective effect of activity was stronger in stroke survivors than in matched adults who did not have a stroke.
Key findings
01Higher prestroke physical activity was associated with fewer limitations in basic activities of daily living (ADLs) in people with stroke, and this effect was statistically stronger than in matched adults without stroke.
02Physically active participants showed fewer limitations in instrumental activities of daily living (IADLs), but there was no evidence that the effect of physical activity on IADLs differed between people with stroke and adults without stroke.
03Functional limitations in both ADLs and IADLs increased at a higher rate over time in people with stroke compared to adults without stroke.
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
Stroke characteristics such as subtype (ischemic vs. hemorrhagic) and specific impairments (motor vs. cognitive) were not available, which may explain differences in findings between ADLs and IADLs. Stroke status and physical activity levels were self-reported, which introduces potential memory bias and inaccuracies compared to device-based measures. The study is observational and cannot prove that physical activity directly caused the better functional outcomes; it only shows an association.
Declared interests
The study was funded by the Canada Foundation for Innovation, Mitacs-Banting Discovery Postdoctoral Fellowship, German Ministry of Education and Research, Max Planck Society, and the U.S. National Institute on Aging. The funders played no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not interpret these results as evidence that starting physical activity after a stroke will reverse these specific long-term limitations. The study measured activity levels before the stroke occurred, so it describes a protective association of prior fitness, not the efficacy of post-stroke rehabilitation exercise.