Research Article| Volume 25, ISSUE 3, P527-532, March 2016

Download started.


Do Physically Active Patients Have Better Functional Outcome after Stroke? A Systematic Review

      Background and Purpose

      Stroke is one of the major causes of mortality and, among survivors, disability. Physical activity has a protective effect maybe due to a major control of risk factors, such as hypertension, diabetes mellitus, and body weight. However, the effect of prestroke physical activity and the poststroke functional outcomes needs clarification.


      We made a systematic review of the literature to elucidate this effect through electronic search in the MEDLINE/PubMed database. Prisma statement was used as a basis for this systematic review and analysis of the risk of bias was made according to the Grading of Recommendations, Assessment, Development and Evaluation. Three studies were finally analyzed in this review.


      The largest of the studies (Rist et al) revealed no association between prior physical activity and functional outcome after stroke. The second major study (Stroud et al) showed only a slight association. Only the smallest of the 3 studies (Krarup et al) showed a protective effect of physical activity.


      The evidence of the protective effect of physical activity is still conflicting. Better longitudinal studies are still needed to see the real effect of physical activity on functional outcome after stroke.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gadidi V.
        • Katz-Leurer M.
        • Carmeli E.
        • et al.
        Long-term outcome poststroke: predictors of activity limitation and participation restriction.
        Arch Phys Med Rehabil. 2011; 92: 1802-1808
        • Oliveira-Filho J.
        • Martins S.C.
        • Pontes-Neto O.M.
        • et al.
        Guidelines for acute ischemic stroke treatment: part I.
        Arq Neuropsiquiatr. 2012; 70: 621-629
        • Mozaffarian D.
        • Benjamin E.J.
        • Go A.S.
        • et al.
        Heart disease and stroke statistics-2015 update: a report from the American Heart Association.
        Circulation. 2015; 131: e29-e322
        • Goldstein L.B.
        • Bushnell C.D.
        • Adams R.J.
        • et al.
        Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.
        Stroke. 2011; 42: 517-584
        • Judith Mackay G.A.M.
        • World Health Organization Staff
        • Myriad Editions Limited Staff
        • Center for Disease Control Staff
        Atlas of heart disease and stroke.
        World Health Organization, Geneva2004
        • Lee C.D.
        • Folsom A.R.
        • Blair S.N.
        Physical activity and stroke risk: a meta-analysis.
        Stroke. 2003; 34: 2475-2481
        • Wendel-Vos G.C.
        • Schuit A.J.
        • Feskens E.J.
        • et al.
        Physical activity and stroke. A meta-analysis of observational data.
        Int J Epidemiol. 2004; 33: 787-798
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • et al.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        J Clin Epidemiol. 2009; 62: 1006-1012
        • Schünemann H.B.J.
        • Guyatt G.
        • Oxman A.
        GRADE handbook for grading quality of evidence and strength of recommendations.
        ([updated October 2013; cited Feb 25, 2015]. Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach.]; Available at:) (Accessed February 8, 2015)
        • Rist P.M.
        • Lee I.M.
        • Kase C.S.
        • et al.
        Physical activity and functional outcomes from cerebral vascular events in men.
        Stroke. 2011; 42: 3352-3356
        • Stroud N.
        • Mazwi T.M.
        • Case L.D.
        • et al.
        Prestroke physical activity and early functional status after stroke.
        J Neurol Neurosurg Psychiatry. 2009; 80: 1019-1022
        • Krarup L.H.
        • Truelsen T.
        • Gluud C.
        • et al.
        Prestroke physical activity is associated with severity and long-term outcome from first-ever stroke.
        Neurology. 2008; 71: 1313-1318
        • Deplanque D.
        • Masse I.
        • Libersa C.
        • et al.
        Previous leisure-time physical activity dose dependently decreases ischemic stroke severity.
        Stroke Res Treat. 2012; 2012: 614925
        • Deplanque D.
        • Masse I.
        • Lefebvre C.
        • et al.
        Prior TIA, lipid-lowering drug use, and physical activity decrease ischemic stroke severity.
        Neurology. 2006; 67: 1403-1410