title: Physical activity and functional outcomes from cerebral vascular events in men.
abstract: OBJECTIVE
  In studies enrolling patients with stroke, higher levels of prestroke physical activity are associated with better functional outcomes. However, prospective studies evaluating this association are sparse. Using a cohort of initially healthy men, we aimed to prospectively assess the association between physical activity and functional outcomes from cerebral vascular events.
  
  
  METHODS
  We conducted a prospective cohort study among 21 794 men enrolled in the Physician's Health Study who provided information on physical activity at baseline and who did not have a history of stroke or transient ischemic attack (TIA). Baseline levels of physical activity were categorized as: vigorous exercise<1, 1, 2 to 4, and ≥5 times/week. Possible functional outcomes included TIA and stroke with modified Rankin Scale score of 0 to 1, 2 to 3, or 5 to 6. Multinomial logistic regression was used to determine the association between physical activity and functional outcomes from cerebral vascular events.
  
  
  RESULTS
  After a mean of 20.2 years of follow-up, 761 TIAs, 1146 ischemic strokes, 221 hemorrhagic strokes, and 11 strokes of unknown type occurred. Compared with men who did not experience a stroke or TIA and who exercise vigorously<1 time/week, men who exercise vigorously≥5 times/week had adjusted relative risk (95% CIs) of 0.67 (0.53-0.86) for TIA, 0.84 (0.61-1.14) for stroke with modified Rankin Scale score 0 to 1, 0.85 (0.67-1.08) for modified Rankin Scale score 2 to 3, and 1.12 (0.78-1.60) for modified Rankin Scale score 5 to 6 after total stroke. Other levels of physical activity did not have a significant impact on the risk of our outcomes.
  
  
  CONCLUSIONS
  Physical activity before TIA or stroke does not appear to influence functional outcomes after cerebral vascular events.
authors.affiliation: Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Pamela M
authors.initials: PM
authors.lastname: Rist
authors.forename: I-Min
authors.initials: IM
authors.lastname: Lee
authors.forename: Carlos S
authors.initials: CS
authors.lastname: Kase
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
authors.forename: Tobias
authors.initials: T
authors.lastname: Kurth
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D020300:Intracranial Hemorrhages / Q000503:physiopathology*; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012307:Risk Factors; D020521:Stroke / Q000503:physiopathology*; D011795:Surveys and Questionnaires