Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors

Hou, Lisha; Li, Mier; Ju, Wang; Li, Yawen; Zheng, Qianwen; Zhang, Lu; Yao, Qiang; Zhang, Jing; Dong, Shuju; Zhou, Muke; Zhu, Cairong

doi:10.1038/s41598-021-92736-5

Cited by 22 publications

(15 citation statements)

References 36 publications

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“…Interventions involving physical activity are also an accessible way of reducing the symptoms of severe anxiety or mental illness among adults, including schizophrenia-spectrum disorders, major depressive disorder, and bipolar disorder [ 14 – 18 ]. The effects of physical activity as an additional or stand-alone treatment are sustained in the case of other medical conditions such as: alcohol use disorder [ 19 – 23 ]; functional outcome after stroke [ 24 – 30 ]; cardiovascular disease [ 31 ]; type 2 diabetes [ 32 ]; cancer [ 33 ]. This double role of physical activity [ 34 ] reflects its negative association with demand of health services, which could lead to lower spending on healthcare systems [ 3 , 35 – 37 ].…”

Section: Introductionmentioning

confidence: 99%

Physical activity and healthcare utilization in France: evidence from the European Health Interview Survey (EHIS) 2014

et al. 2022

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Background A growing need and focus on preventing and controlling the diseases and promoting a healthier lifestyle is more evident at global, regional, and national levels. In this respect, it is well-known the positive association between physical activity and population’s health, but also its negative association with the demand of healthcare, which could lead to lower spending on healthcare systems. In France, a lack of physical activity, a high prevalence of sedentary behaviours, and a continuous deterioration of these behaviours are observed since 2006. Therefore, promoting and increasing physical activities could contribute to major societal issues. Within this context, the study aims to analyse how the use of different healthcare services are related to physical activity in a nationally representative sample of French population. Methods The data used was retrieved from the second wave of the EHIS-ESPS 2014. The relationship between physical activity and healthcare utilization, controlled by a set of socioeconomic, demographic, and health behaviour factors, was explored both at the level of the entire population and separately for two age groups (less than 65 years, 65 years and older), employing probit and recursive multivariate probit models. Results Our findings underline that the relation between healthcare utilization and physical activity depends on the type of healthcare services and age group. In this respect, only among adult respondents, we observe a significant negative association between physical activity and prescribed medicines consumption and day hospitalization, while preventive services use is positively related to physical activity. Common to both age groups, the positive association of physical activity with general physician services and non-prescribed medicines reveal that moderately and highly active adults and elders may be more health conscious and therefore may seek referrals to generalist and other prevention measures more frequently than their inactive counterparts. This explanation is also sustained by the negative association between physical activity and overnight hospitalization or home healthcare services. Conclusions This study highlights the double role of physical activity on health as preventive measure and treatment and thus support the implementation of public health policies aimed at increasing the level of physical activity in French population.

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Section: Introductionmentioning

confidence: 99%

Physical activity and healthcare utilization in France: evidence from the European Health Interview Survey (EHIS) 2014

et al. 2022

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“…The risk of stroke recurrence in subjects with prolonged sitting hours (≥12 h) was four times higher than in those with shorter sitting hours, thus indicating that physical inactivity increases the risk of stroke relapse ( 93 , 94 ). Most stroke survivors are engaged in physical inactivity and sedentary behavior, due to many barriers including depression, low motivation, poor to moderate social support, and physical impairment ( 95 ).…”

Section: Discussionmentioning

confidence: 98%

One-year recurrence of stroke and death in Lebanese survivors of first-ever stroke: Time-to-Event analysis

et al. 2022

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BackgroundTo date, despite the application of secondary prevention worldwide, first-ever stroke survivors remain at imminent risk of stroke recurrence and death in the short and long term. The present study aimed to assess the cumulative risk rates and identify baseline differences and stroke characteristics of Lebanese survivors.MethodsA prospective longitudinal study was conducted among survivors ≥18 years old who were followed-up for 15 months through a face-to-face interview. Kaplan–Meier method was used to calculate the cumulative rates of stroke mortality and recurrence. Cox-regression univariate and multivariable analyses were performed to identify the predictors of both outcomes.ResultsAmong 150 subjects (mean age 74 ± 12 years; 58.7% men vs. 44.3% women; 95.3% with ischemic stroke vs. 4.3% with intracerebral hemorrhage), high cumulative risk rates of stroke recurrence (25%) and death (21%) were highlighted, especially in the acute phase. Survival rates were lesser in patients with stroke recurrence compared to those without recurrence (Log rank test p < 0.001). Older age was the main predictor for both outcomes (p < 0.02). Large artery atherosclerosis was predominant in patients with stroke recurrence and death compared to small vessel occlusion (p < 0.02). Higher mental component summary scores of quality of life were inversely associated with stroke recurrence (p < 0.01). Lebanese survivors exhibited the highest percentages of depression and anxiety; elevated Hospital Anxiety and Depression Scale (HADS) scores were seen in those with stroke recurrence and those who died (≥80% with mean HADS scores ≥8). Lower Mini-Mental State Examination scores at the acute phase increased the risk of both outcomes by 10% (p < 0.03). Three out of 13 mortalities (23.1%) were presented with early epileptic seizures (p = 0.012). High educational level was the protective factor against stroke recurrence (p = 0.019). Administration of intravenous thrombolysis decreased the risk of both outcomes by 10% (p > 0.05).ConclusionHigher rates of stroke recurrence and death were observed in the first year following a stroke in Lebanon. Various factors were identified as significant determinants. Thus, health care providers and officials in Lebanon can use these findings to implement effective preventive strategies to best address the management of these factors to reduce the stroke burden and improve the short and long-term prognosis of stroke survivors.

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“…Clinical studies have documented that physical activity and exercise enhance neuroplasticity and change brain activity patterns in post-stroke survivors, reducing the risk of recurrence (Kramer et al, 2019). A dose-response relationship has been identified between physical activity duration and stroke recurrence as well (Hou et al, 2021). Regular exercise results in genome-wide epigenetic modifications in human skeletal muscle and adipose tissue, which could affect metabolic phenotypes associated with stroke (Ling and Rönn, 2014).…”

Section: Discussionmentioning

confidence: 99%

Thirty-six months recurrence after acute ischemic stroke among patients with comorbid type 2 diabetes: A nested case-control study

Wang

Liu

Hao

et al. 2022

Front. Aging Neurosci.

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BackgroundStroke patients have to face a high risk of recurrence, especially for those with comorbid T2DM, which usually lead to much more serious neurologic damage and an increased likelihood of death. This study aimed to explore determinants of stroke relapse among patients with comorbid T2DM.Materials and methodsWe conducted this case-control study nested a prospective cohort of ischemic stroke (IS) with comorbid T2DM. During 36-month follow-up, the second stroke occurred in 84 diabetic IS patients who were allocated into the case group, while 613 patients without recurrence were the controls. We collected the demographic data, behaviors and habits, therapies, and family history at baseline, and measured the variables during follow-up. LASSO and Logistic regression analyses were carried out to develop a prediction model of stroke recurrence. The receiver operator characteristic (ROC) curve was employed to evaluate the performance of the prediction model.ResultsCompared to participants without recurrence, the higher levels of pulse rate (78.29 ± 12.79 vs. 74.88 ± 10.93) and hypertension (72.6 vs. 61.2%) were recorded at baseline. Moreover, a lower level of physical activity (77.4 vs. 90.4%), as well as a higher proportion of hypoglycemic therapy (36.9 vs. 23.3%) was also observed during 36-month follow-up. Multivariate logistic regression revealed that higher pulse rate at admission (OR = 1.027, 95 %CI = 1.005–1.049), lacking physical activity (OR = 2.838, 95% CI = 1.418–5.620) and not receiving hypoglycemic therapy (OR = 1.697, 95% CI = 1.013–2.843) during follow-up increased the risk of stroke recurrence. We developed a prediction model using baseline pulse rate, hypoglycemic therapy, and physical activity, which produced an area under ROC curve (AUC) of 0.689.ConclusionPhysical activity and hypoglycemic therapy play a protective role for IS patients with comorbid diabetes. In addition to targeted therapeutics, the improvement of daily-life habit contributes to slowing the progress of the IS.

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Association between physical exercise and stroke recurrence among first-ever ischemic stroke survivors

Cited by 22 publications

References 36 publications

Physical activity and healthcare utilization in France: evidence from the European Health Interview Survey (EHIS) 2014

Physical activity and healthcare utilization in France: evidence from the European Health Interview Survey (EHIS) 2014

One-year recurrence of stroke and death in Lebanese survivors of first-ever stroke: Time-to-Event analysis

Thirty-six months recurrence after acute ischemic stroke among patients with comorbid type 2 diabetes: A nested case-control study

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