Physical Activity and Functional Outcomes From Cerebral Vascular Events in Men

Background and Purpose-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. (Stroke. 2011;42:3352-3356.)