title: Physical activity in the prevention of ischemic stroke and improvement of outcomes: a narrative review.
abstract: Physical activity is an integral component of stroke prevention. Although approximately 80% of strokes are due to cerebral ischemia, the mechanisms linking physical activity to the incidence of and recovery from ischemic stroke are not completely understood. This review summarizes evidence from human and animal studies regarding physical activity in the prevention of overt and covert ischemic stroke and associated injury. In cohort studies, people who are physically active have reduced rates of overt ischemic stroke and ischemic stroke mortality. However, few human studies have examined physical activity and the incidence of covert stroke. Evidence from animal models of ischemic stroke indicates that physical activity reduces injury after ischemic stroke by reducing infarct size and apoptotic cell death. Accordingly, physical activity may reduce the magnitude of injury from ischemic stroke so that there are fewer or less severe symptoms. Future research should investigate physical activity and incidence of covert stroke prospectively, ascertain the optimal dose and type of exercise to prevent ischemic injury, and identify the underlying neuroprotective mechanisms.
authors.affiliation: Department of Kinesiology, 200 University Ave W, University of Waterloo, Waterloo, ON N2G 3G1, Canada. Laura.middleton@uwaterloo.ca
authors.forename: Laura E
authors.initials: LE
authors.lastname: Middleton
authors.forename: Dale
authors.initials: D
authors.lastname: Corbett
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.forename: Michael D
authors.initials: MD
authors.lastname: Sage
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Macintosh
authors.forename: William E
authors.initials: WE
authors.lastname: McIlroy
authors.forename: Sandra E
authors.initials: SE
authors.lastname: Black
mesh_terms: D000818:Animals; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D015331:Cohort Studies; D005081:Exercise Therapy; D006801:Humans; D015994:Incidence; D009410:Nerve Degeneration / Q000517:prevention & control; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D016896:Treatment Outcome