Clinical Research Development Unit, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Neurology and Stroke Unit, San Camillo de' Lellis General Hospital, Rieti, Italy.
Neurol Sci. 2021 Aug;42(8):3203-3210. doi: 10.1007/s10072-020-04903-7. Epub 2020 Nov 25.
Few data are available on the associations between the level of pre-stroke physical activity and long-term outcomes in patients with stroke. This study is designed to assess the associations between pre-stroke physical activity and age of first-ever stroke occurrence and long-term outcomes.
Six hundred twenty-four cases with first-ever stroke were recruited from the Mashhad Stroke Incidence Study a prospective population-based cohort in Iran. Data on Physical Activity Level (PAL) were collected retrospectively and were available in 395 cases. According to the PAL values, subjects were classified as inactive (PAL < 1.70) and active (PAL ≥ 1.70). Age at onset of stroke was compared between active and inactive groups. Using logistic model, we assessed association between pre-stroke physical activity and long-term (5-year) mortality, recurrence, disability, and functional dependency rates. We used multiple imputation to analyze missing data.
Inactive patients (PAL < 1.70) were more than 6 years younger at their age of first-ever-stroke occurrence (60.7 ± 15.5) than active patients (67.0 ± 13.2; p < 0.001). Patients with PAL< 1.7 also had a greater risk of mortality at 1 year [adjusted odds ratio (aOR) = 2.31; 95%CI: 1.14-4.67, p = 0.02] and 5 years after stroke (aOR = 1.81; 95%CI: 1.05-3.14, p = 0.03) than patients who were more physically active. Recurrence rate, disability, and functional dependency were not statistically different between two groups. Missing data analysis also showed a higher odds of death at one and 5 years for inactive patients.
In our cohort, we observed a younger age of stroke and a higher odds of 1- and 5-year mortality among those with less physical activity. This is an important health promotion strategy to encourage people to remain physically active.
关于体力活动水平与卒中患者长期结局之间的关系，目前仅有少量数据。本研究旨在评估体力活动与首次卒中发病年龄和长期结局之间的关系。
本研究纳入了伊朗马什哈德卒中发生率研究中的 624 例首发卒中患者，这是一项前瞻性的基于人群的队列研究。回顾性收集体力活动水平（PAL）数据，其中 395 例患者的数据可用。根据 PAL 值，受试者被分为不活跃（PAL<1.70）和活跃（PAL≥1.70）组。比较活跃组和不活跃组之间的卒中发病年龄。采用 logistic 模型评估卒中前体力活动与长期（5 年）死亡率、复发率、残疾率和功能依赖性之间的关系。我们采用多重插补法分析缺失数据。
首次卒中发病时，不活跃组患者（PAL<1.70）比活跃组患者（PAL≥1.70）年轻 6 岁以上（60.7±15.5 岁比 67.0±13.2 岁；p<0.001）。PAL<1.7 的患者在卒中后 1 年和 5 年的死亡率风险更高[校正后比值比（aOR）=2.31；95%CI：1.14-4.67，p=0.02]和 5 年（aOR=1.81；95%CI：1.05-3.14，p=0.03），比体力活动更活跃的患者更高。两组之间复发率、残疾率和功能依赖性无统计学差异。缺失数据分析也显示，不活跃患者在 1 年和 5 年的死亡风险更高。
在本队列中，我们观察到体力活动较少的患者卒中发病年龄更小，1 年和 5 年死亡率的几率更高。这是一项重要的健康促进策略，鼓励人们保持身体活跃。
