The effectiveness of physical activity in reducing the incidence of stroke

Abstract

Overview: Globally, stroke is a leading cause of disability and mortality. Yet, it has been postulated that it is highly preventable through certain lifestyle changes, such as engagement in physical activity. Research (PICO) question: Among persons over 40 years of age, is physical activity effective in reducing the incidence of stroke? Population: Men and Women aged, 40 years and older Intervention: Regular physical activity/exercise Comparison: No regular physical activity or exercise Outcome: Reducing the incidence of stroke Inclusion criteria: Studies from 2000 onwards, with an adult population aged 40 and above, about the effectiveness of physical activity in preventing stroke; studies published in the English language; systematic reviews, meta-analyses, randomised trials, cohort studies, and case control studies. Exclusion criteria: Studies published prior to 2000; studies with adults younger than 40 years of age, teenagers, neonates and children as their population; studies not published in the English language, studies preventing recurrent of stroke and studies classified as narrative literature reviews and current opinion papers. Outcome of the search: Fourteen studies were retrieved through the search, of which eight met all the inclusion criteria (four meta-analyses, three cohort studies and one case control study). Method of appraisal: The meta-analyses were appraised using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Critical Appraisal Skill Programme ii (CASP) tool for reviews. The cohort studies and case control study were appraised using CASP tools for cohort and case control studies respectively. Main results: The results indicate that increasing physical activity level is strongly associated with a lower risk of most types of stroke. However, additional studies are needed to address the relation between physical activity and haemorrhagic stroke. Conclusion, implications, and recommendations: The findings indicate that engaging in moderate to high PA is beneficial in reducing the incidence of stroke. However, more studies are needed in order to address the relation between PA and haemorrhagic stroke. Moreover, additional studies are needed to clarify whether the same level of PA will be required to achieve the same level of risk reduction between men and women. With encouragement and motivation, even people who cannot tolerate high level of PA can benefit from a moderate level of exercise.