56369The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.
NHMRC Centre of Excellence in Stroke Rehabilitation and Recovery, Melbourne, Australia.
Int J Stroke. 2021 Dec;16(9):1009-1018. doi: 10.1177/1747493021995271. Epub 2021 Feb 23.
Admission stroke severity is an important clinical predictor of stroke outcomes. Pre-stroke physical activity contributes to stroke prevention and may also be associated with reduced stroke severity. Summarizing the evidence to date will inform strategies to reduce burden after stroke.
To summarize the published evidence for the relationship between pre-stroke physical activity and admission stroke severity and to provide recommendations for future research.
MEDLINE, Embase, Emcare, CENTRAL, and gray literature databases were searched on 14 February 2020 using search terms related to stroke and pre-stroke physical activity in adult stroke survivors. We screened 8,152 references and assessed 172 full-text references for eligibility. We included seven studies ( = 41,800 stroke survivors). All studies were observational, assessed pre-stroke physical activity using self-reported questionnaires, and assessed admission stroke severity using the National Institute of Health Stroke Scale. Analyses were categorized as the presence of pre-stroke physical activity (four studies) or dose-response (five studies). In three studies, presence of pre-stroke physical activity was associated with milder stroke severity, and no association in one study. Greater pre-stroke physical activity duration and intensity (two studies) or amount (three studies) were associated with milder stroke severity. Studies ranged between moderate to critical risk of bias, primarily due to confounding factors. Pre-stroke physical activity may be associated with reduced risk factors for severe stroke, distal occlusion, smaller infarcts, and shorter time-to-treatment delivery.
Pre-stroke physical activity may be associated with reduced admission stroke severity. Lack of randomized controlled trials limited causality conclusions. Future research recommendations were provided.
入院时的卒中严重程度是卒中结局的重要临床预测指标。卒中前的身体活动有助于卒中预防，也可能与卒中严重程度降低有关。总结目前的证据将为减轻卒中后负担的策略提供信息。
总结卒中前身体活动与入院时卒中严重程度之间关系的已有证据，并为未来的研究提供建议。
于 2020 年 2 月 14 日，使用与成人卒中幸存者卒中前身体活动相关的检索词，检索了 MEDLINE、Embase、Emcare、CENTRAL 和灰色文献数据库。我们筛选了 8152 篇参考文献，并评估了 172 篇全文参考文献的合格性。我们纳入了 7 项研究（ = 41800 例卒中幸存者）。所有研究均为观察性研究，使用自我报告问卷评估卒中前的身体活动，并使用国立卫生研究院卒中量表评估入院时的卒中严重程度。分析分为存在卒中前身体活动（四项研究）或剂量反应（五项研究）。在三项研究中，存在卒中前身体活动与较轻的卒中严重程度相关，而一项研究中则没有关联。较多的卒中前身体活动持续时间和强度（两项研究）或量（三项研究）与较轻的卒中严重程度相关。研究的偏倚风险介于中度至临界之间，主要是由于混杂因素。卒中前身体活动可能与降低严重卒中、远端闭塞、较小的梗死灶和较短的治疗时间有关。
卒中前身体活动可能与入院时的卒中严重程度降低有关。缺乏随机对照试验限制了因果关系的结论。提供了未来研究的建议。
