Skip to main content

Advertisement

SpringerLink
Log in

The Impact of Physical Activity Before and After Stroke on Stroke Risk and Recovery: a Narrative Review

  • Stroke (H.C. Diener, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

Summarising the evidence for pre- and post-stroke physical activity (PA) and exercise to reduce stroke risk, and improve recovery and brain health.

Recent Findings

Pre-stroke PA reduces the risk of stroke, and post-stroke PA and exercise reduce cardiovascular risk factors, which can moderate the risk of recurrent strokes. Pre-clinical evidence indicates that exercise enhances neuroplasticity. The results from clinical studies showed that exercise changes brain activity patterns in stroke survivors, which can be a signal neuroplasticity. The intensity of pre- and post-stroke PA and exercise is a key factor with higher intensities leading to greater benefits, including improvement in fitness. Having low fitness levels is an independent predictor for increased risk of stroke.

Summary

Higher intensity leads to greater benefits; however, the optimum intensity of PA and exercise is yet unknown and needs to be further investigated. Strategies to decrease sedentary behaviour and improve fitness need to be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Australian Institute of Health and Welfare. Australia’s health 2018. Australia’s Health Series No. 16, 2018.

  2. Zhang Y, Chapman AM, Plested M, Jackson D, Purroy F. The incidence, prevalence, and mortality of stroke in France, Germany, Italy, Spain, the UK, and the US: a literature review. Stroke Res Treat. 2012;2012:436125.

    PubMed  PubMed Central  Google Scholar 

  3. The economic impact of stroke in Australia. Deloitte Access Economics commisioned by the Stroke Foundation. In: 2013.

  4. O'Donnell MJ, Chin SL, Rangarajan S, Xavier D, Liu L, Zhang H, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet. 2016;388(10046):761–75.

    PubMed  Google Scholar 

  5. Warburton DE, Nicol CW, Bredin SS. Health benefits of physical activity: the evidence. CMAJ. 2006;174(6):801–9.

    PubMed  PubMed Central  Google Scholar 

  6. •• Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol. 2017;32(5):541–56 This is a systematic review of systematic reviews demonstrating the dose-reponse relationship between physical activity and the reduced risk of various chronic conditions (such as cardiovascular disease, some types of cancers, type-2 diabetes) and all-cause mortality in adults and adolescents.

    PubMed  Google Scholar 

  7. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatr. 2005;18(2):189–93.

    Google Scholar 

  8. Kramer AF, Erickson KI. Effects of physical activity on cognition, well-being, and brain: human interventions. Alzheimers Dement. 2007;3(2 Suppl):S45–51.

    PubMed  Google Scholar 

  9. Erickson KI, Hillman CH, Kramer AF. Physical activity, brain, and cognition. Current Opinion in Behavioural Sciences. 2015;4:27–33.

    Google Scholar 

  10. Cotman CW, Berchtold NC. Exercise: a behavioral intervention to enhance brain health and plasticity. Trends Neurosci. 2002;25(6):295–301.

    CAS  PubMed  Google Scholar 

  11. Tolppanen AM, Solomon A, Kulmala J, Kåreholt I, Ngandu T, Rusanen M, et al. Leisure-time physical activity from mid- to late life, body mass index, and risk of dementia. Alzheimers Dement. 2015;11(4):434–443 e436.

    PubMed  Google Scholar 

  12. Podewils LJ, Guallar E, Kuller LH, Fried LP, Lopez OL, Carlson M, et al. Physical activity, APOE genotype, and dementia risk: findings from the Cardiovascular Health Cognition Study. Am J Epidemiol. 2005;161(7):639–51.

    PubMed  Google Scholar 

  13. Reinholdsson M, Palstam A, Sunnerhagen KS. Prestroke physical activity could influence acute stroke severity (part of PAPSIGOT). Neurology. 2018;91(16):e1461–7.

    PubMed  PubMed Central  Google Scholar 

  14. Ploughman M, Austin MW, Glynn L, Corbett D. The effects of poststroke aerobic exercise on neuroplasticity: a systematic review of animal and clinical studies. Transl Stroke Res. 2015;6(1):13–28.

    PubMed  Google Scholar 

  15. • Saunders DH, Sanderson M, Hayes S, et al. Physical fitness training for stroke patients. Cochrane Database Syst Rev. 2016;(3):CD003316 This is review provides strong evidence for the effrcts of exercise to improve cardiorespiartory fitness. The recommendation regarding exrcise in current clinical guidelines is based on this eveidence.

  16. Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Pate RR. A new definition of youth fitness. Physician Sportsmed. 1983;11:77–83.

    Google Scholar 

  18. Lee CD, Folsom AR, Blair SN. Physical activity and stroke risk: a meta-analysis. Stroke. 2003;34(10):2475–81.

    PubMed  Google Scholar 

  19. Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864–70.

    CAS  PubMed  Google Scholar 

  20. Decourcelle A, Moulin S, Sibon I, Murao K, Ronzière T, Godefroy O, et al. Influence of previous physical activity on the outcome of patients treated by thrombolytic therapy for stroke. J Neurol. 2015;262(11):2513–9.

    PubMed  Google Scholar 

  21. Deplanque D, Masse I, Lefebvre C, Libersa C, Leys D, Bordet R. Prior TIA, lipid-lowering drug use, and physical activity decrease ischemic stroke severity. Neurology. 2006;67(8):1403–10.

    CAS  PubMed  Google Scholar 

  22. Deplanque D, Masse I, Libersa C, Leys D, Bordet R. Previous leisure-time physical activity dose dependently decreases ischemic stroke severity. Stroke Res Treat. 2012;2012:614925.

    PubMed  Google Scholar 

  23. Krarup LH, Truelsen T, Gluud C, et al. Prestroke physical activity is associated with severity and long-term outcome from first-ever stroke. Neurology. 2008;71(17):1313–8.

    PubMed  Google Scholar 

  24. • Lopez-Cancio E, Ricciardi AC, Sobrino T, et al. Reported prestroke physical activity is associated with vascular endothelial growth factor expression and good outcomes after stroke. J Stroke Cerebrovasc Dis. 2017;26(2):425–30 In addition to demonstrating a reduction in stroke severity with physical activity participation, the authors also demonstrated that increased physical activity levels are related to smaller infarct volumes and higher levels of vascular endothelial growth factor expression. These findings highlight a clinically relevant basis for the relationship between stroke severity and physical activity.

    PubMed  Google Scholar 

  25. Ricciardi AC, Lopez-Cancio E, Perez de la Ossa N, et al. Prestroke physical activity is associated with good functional outcome and arterial recanalization after stroke due to a large vessel occlusion. Cerebrovasc Dis. 2014;37(4):304–11.

    PubMed  Google Scholar 

  26. Stroud N, Mazwi TM, Case LD, et al. Prestroke physical activity and early functional status after stroke. J Neurol Neurosurg Psychiatry. 2009;80(9):1019–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Ursin MH, Ihle-Hansen H, Fure B, Tveit A, Bergland A. Effects of premorbid physical activity on stroke severity and post-stroke functioning. J Rehabil Med. 2015;47(7):612–7.

    PubMed  Google Scholar 

  28. Wen CP, Liu CH, Jeng JS, Hsu SP, Chen CH, Lien LM, et al. Pre-stroke physical activity is associated with fewer post-stroke complications, lower mortality and a better long-term outcome. Eur J Neurol. 2017;24(12):1525–31.

    PubMed  Google Scholar 

  29. Thijs VN, Lansberg MG, Beaulieu C, Marks MP, Moseley ME, Albers GW. Is early ischemic lesion volume on diffusion-weighted imaging an independent predictor of stroke outcome? A multivariable analysis. Stroke. 2000;31(11):2597–602.

    CAS  PubMed  Google Scholar 

  30. Blauenfeldt RA, Hougaard KD, Mouridsen K, Andersen G. High prestroke physical activity is associated with reduced infarct growth in acute ischemic stroke patients treated with intravenous tPA and randomized to remote ischemic perconditioning. Cerebrovasc Dis. 2017;44(1–2):88–95.

    CAS  PubMed  Google Scholar 

  31. Euser AM, Zoccali C, Jager KJ, Dekker FW. Cohort studies: prospective versus retrospective. Nephron Clin Pract. 2009;113(3):c214–7.

    PubMed  Google Scholar 

  32. Rist PM, Lee IM, Kase CS, Gaziano JM, Kurth T. Physical activity and functional outcomes from cerebral vascular events in men. Stroke. 2011;42(12):3352–6.

    PubMed  PubMed Central  Google Scholar 

  33. Bell CL, LaCroix A, Masaki K, Hade EM, Manini T, Mysiw WJ, et al. Prestroke factors associated with poststroke mortality and recovery in older women in the Women’s Health Initiative. J Am Geriatr Soc. 2013;61(8):1324–30.

    PubMed  PubMed Central  Google Scholar 

  34. Grimby G, Borjesson M, Jonsdottir IH, et al. The “Saltin-Grimby Physical Activity Level Scale” and its application to health research. Scand J Med Sci Sports. 2015;25 Suppl 4:119–25.

    PubMed  Google Scholar 

  35. Washburn RA, Smith KW, Jette AM, Janney CA. The Physical Activity Scale for the Elderly (PASE): development and evaluation. J Clin Epidemiol. 1993;46(2):153–62.

    CAS  PubMed  Google Scholar 

  36. Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.

    PubMed  Google Scholar 

  37. Prince SA, Adamo KB, Hamel ME, Hardt J, Connor Gorber S, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5:56.

    PubMed  PubMed Central  Google Scholar 

  38. Austin H, Hill HA, Flanders WD, Greenberg RS. Limitations in the application of case-control methodology. Epidemiol Rev. 1994;16(1):65–76.

    CAS  PubMed  Google Scholar 

  39. Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575–81.

    PubMed  Google Scholar 

  40. Fini NA, Holland AE, Keating J, Simek J, Bernhardt J. How physically active are people following stroke? Systematic review and quantitative synthesis. Phys Ther. 2017;97(7):707–17.

    PubMed  Google Scholar 

  41. Smith AC, Saunders DH, Mead G. Cardiorespiratory fitness after stroke: a systematic review. Int J Stroke. 2012;7(6):499–510.

    PubMed  Google Scholar 

  42. Baert I, Daly D, Dejaeger E, Vanroy C, Vanlandewijck Y, Feys H. Evolution of cardiorespiratory fitness after stroke: a 1-year follow-up study. Influence of prestroke patients’ characteristics and stroke-related factors. Arch Phys Med Rehabil. 2012;93(4):669–76.

    PubMed  Google Scholar 

  43. Kleindorfer D, Panagos P, Pancioli A, Khoury J, Kissela B, Woo D, et al. Incidence and short-term prognosis of transient ischemic attack in a population-based study. Stroke. 2005;36(4):720–3.

    PubMed  Google Scholar 

  44. Johnston SC, Sidney S, Bernstein AL, Gress DR. A comparison of risk factors for recurrent TIA and stroke in patients diagnosed with TIA. Neurology. 2003;60(2):280–5.

    PubMed  Google Scholar 

  45. Coull AJ, Lovett JK, Rothwell PM. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: implications for public education and organisation of services. BMJ. 2004;328(7435):326.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. Lovett JK, Coull AJ, Rothwell PM. Early risk of recurrence by subtype of ischemic stroke in population-based incidence studies. Neurology. 2004;62(4):569–73.

    CAS  PubMed  Google Scholar 

  47. Prior PL, Hachinski V, Unsworth K, Chan R, Mytka S, O'Callaghan C, et al. Comprehensive cardiac rehabilitation for secondary prevention after transient ischemic attack or mild stroke: I: feasibility and risk factors. Stroke. 2011;42(11):3207–13.

    PubMed  Google Scholar 

  48. • D'Isabella NT, Shkredova DA, Richardson JA, Tang A. Effects of exercise on cardiovascular risk factors following stroke or transient ischemic attack: a systematic review and meta-analysis. Clin Rehabil. 2017;31(12):1561–72 The authors of this paper identified that there is an effect between exercise based interventions and cardiovascular risk factors in stroke survivors.

    PubMed  Google Scholar 

  49. Gallanagh S, Quinn TJ, Alexander J, Walters MR. Physical activity in the prevention and treatment of stroke. ISRN Neurol. 2011;2011:953818.

    PubMed  PubMed Central  Google Scholar 

  50. Billinger SA, Arena R, Bernhardt J, Eng JJ, Franklin BA, Johnson CM, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(8):2532–53.

    PubMed  Google Scholar 

  51. Mackay-Lyons M, Macko RF, Eng JJ, et al. AEROBICS: aerobic exercise recommendations to optimize best practice after stroke. In: 2013.

  52. Fini NA, Holland AE, Keating J, Simek J, Bernhardt J. How is physical activity monitored in people following stroke? Disabil Rehabil. 2015;37(19):1717–31.

    PubMed  Google Scholar 

  53. Lynch EA, Jones TM, Simpson DB, et al. Activity monitors for increasing physical activity in adult stroke survivors. Cochrane Database Syst Rev. 2018;(7):CD012543.

  54. Kono Y, Kawajiri H, Kamisaka K, Kamiya K, Akao K, Asai C, et al. Predictive impact of daily physical activity on new vascular events in patients with mild ischemic stroke. Int J Stroke. 2015;10(2):219–23.

    PubMed  Google Scholar 

  55. Schmidt W, Endres M, Dimeo F, Jungehulsing GJ. Train the vessel, gain the brain: physical activity and vessel function and the impact on stroke prevention and outcome in cerebrovascular disease. Cerebrovasc Dis. 2013;35(4):303–12.

    PubMed  Google Scholar 

  56. Greenberg DA, Jin K. Vascular endothelial growth factors (VEGFs) and stroke. Cell Mol Life Sci. 2013;70(10):1753–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  57. Vital TM, Stein AM, de Melo Coelho FG, Arantes FJ, Teodorov E, Santos-Galduróz RF. Physical exercise and vascular endothelial growth factor (VEGF) in elderly: a systematic review. Arch Gerontol Geriatr. 2014;59(2):234–9.

    CAS  PubMed  Google Scholar 

  58. Binder DK, Scharfman HE. Brain-derived neurotrophic factor. Growth Factors. 2004;22(3):123–31.

    CAS  PubMed  PubMed Central  Google Scholar 

  59. Mang CS, Campbell KL, Ross CJ, Boyd LA. Promoting neuroplasticity for motor rehabilitation after stroke: considering the effects of aerobic exercise and genetic variation on brain-derived neurotrophic factor. Phys Ther. 2013;93(12):1707–16.

    PubMed  PubMed Central  Google Scholar 

  60. Mackay CP, Kuys SS, Brauer SG. The effect of aerobic exercise on brain-derived neurotrophic factor in people with neurological disorders: a systematic review and meta-analysis. Neural Plast. 2017;2017:4716197.

    PubMed  PubMed Central  Google Scholar 

  61. Huang T, Larsen KT, Ried-Larsen M, Moller NC, Andersen LB. The effects of physical activity and exercise on brain-derived neurotrophic factor in healthy humans: a review. Scand J Med Sci Sports. 2014;24(1):1–10.

    PubMed  Google Scholar 

  62. Ploughman M, Granter-Button S, Chernenko G, Attwood Z, Tucker BA, Mearow KM, et al. Exercise intensity influences the temporal profile of growth factors involved in neuronal plasticity following focal ischemia. Brain Res. 2007;1150:207–16.

    CAS  PubMed  Google Scholar 

  63. Rothwell PM, Howard SC, Power DA, Gutnikov SA, Algra A, van Gijn J, et al. Fibrinogen concentration and risk of ischemic stroke and acute coronary events in 5113 patients with transient ischemic attack and minor ischemic stroke. Stroke. 2004;35(10):2300–5.

    CAS  PubMed  Google Scholar 

  64. Lin Y, Liu Z, Qiu Y, Zhang J, Wu H, Liang R, et al. Clinical significance of plasma D-dimer and fibrinogen in digestive cancer: a systematic review and meta-analysis. Eur J Surg Oncol. 2018;44(10):1494–503.

    PubMed  Google Scholar 

  65. Schuit AJ, Schouten EG, Kluft C, de Maat M, Menheere PP, Kok FJ. Effect of strenuous exercise on fibrinogen and fibrinolysis in healthy elderly men and women. Thromb Haemost. 1997;78(2):845–51.

    CAS  PubMed  Google Scholar 

  66. Ernst E. Regular exercise reduces fibrinogen levels: a review of longitudinal studies. Br J Sports Med. 1993;27(3):175–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. Kleim JA, Jones TA. Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear R. 2008;51(1):S225–39.

    Google Scholar 

  68. Murphy TH, Corbett D. Plasticity during stroke recovery: from synapse to behaviour. Nat Rev Neurosci. 2009;10(12):861–72.

    CAS  PubMed  Google Scholar 

  69. •• Ploughman M, Kelly LP. Four birds with one stone? Reparative, neuroplastic, cardiorespiratory, and metabolic benefits of aerobic exercise poststroke. Curr Opin Neurol. 2016;29(6):684–92 This narrative review provides an overview of pre-clinical and clinical evidence for aerobic exercise to enahance neuroplasticity and optimise recovery after stroke; the authors created a model of aerobic exercise training that can be applied in subacute stroke.

    PubMed  Google Scholar 

  70. Enzinger C, Dawes H, Johansen-Berg H, Wade D, Bogdanovic M, Collett J, et al. Brain activity changes associated with treadmill training after stroke. Stroke. 2009;40(7):2460–7.

    PubMed  Google Scholar 

  71. Landsmann B, Pinter D, Pirker E, Pichler G, Schippinger W, Weiss EM, et al. An exploratory intervention study suggests clinical benefits of training in chronic stroke to be paralleled by changes in brain activity using repeated fMRI. Clin Interv Aging. 2016;11:97–103.

    PubMed  PubMed Central  Google Scholar 

  72. Luft AR, Macko RF, Forrester LW, Villagra F, Ivey F, Sorkin JD, et al. Treadmill exercise activates subcortical neural networks and improves walking after stroke: a randomized controlled trial. Stroke. 2008;39(12):3341–50.

    PubMed  PubMed Central  Google Scholar 

  73. Kurl S, Laukkanen JA, Rauramaa R, Lakka TA, Sivenius J, Salonen JT. Cardiorespiratory fitness and the risk for stroke in men. Arch Intern Med. 2003;163(14):1682–8.

    PubMed  Google Scholar 

  74. Lee CD, Blair SN. Cardiorespiratory fitness and stroke mortality in men. Med Sci Sports Exerc. 2002;34(4):592–5.

    PubMed  Google Scholar 

  75. Voss MW, Weng TB, Burzynska AZ, Wong CN, Cooke GE, Clark R, et al. Fitness, but not physical activity, is related to functional integrity of brain networks associated with aging. Neuroimage. 2016;131:113–25.

    PubMed  Google Scholar 

  76. Bouchard C, Blair SN, Katzmarzyk PT. Less sitting, more physical activity, or higher fitness? Mayo Clin Proc. 2015;90:1533–40.

    PubMed  Google Scholar 

  77. Egan B, Carson BP, Garcia-Roves PM, Chibalin AV, Sarsfield FM, Barron N, et al. Exercise intensity-dependent regulation of peroxisome proliferator-activated receptor coactivator-1 mRNA abundance is associated with differential activation of upstream signalling kinases in human skeletal muscle. J Physiol. 2010;588(Pt 10):1779–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  78. Gormley SE, Swain DP, High R, et al. Effect of intensity of aerobic training on VO2 max. Med Sci Sports Exerc. 2008;40(7):1336–43.

    PubMed  Google Scholar 

  79. Chase JA, Conn VS. Meta-analysis of fitness outcomes from motivational physical activity interventions. Nurs Res. 2013;62(5):294–304.

    PubMed  PubMed Central  Google Scholar 

  80. Bravata DM, Wells CK, Brass LM, Morgan T, Lichtman JH, Concato J. Dietary fish or seafood consumption is not related to cerebrovascular disease risk in twin veterans. Neuroepidemiology. 2007;28(3):186–90.

    PubMed  Google Scholar 

  81. Dunn AL, Marcus BH, Kampert JB, Garcia ME, Kohl HW 3rd, Blair SN. Comparison of lifestyle and structured interventions to increase physical activity and cardiorespiratory fitness: a randomized trial. JAMA. 1999;281(4):327–34.

    CAS  PubMed  Google Scholar 

  82. Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity. A systematic review. Am J Prev Med. 2002;22(4 Suppl):73–107.

    PubMed  Google Scholar 

  83. Hawley JA, Hargreaves M, Joyner MJ, Zierath JR. Integrative biology of exercise. Cell. 2014;159(4):738–49.

    CAS  PubMed  Google Scholar 

  84. •• Delezie J, Handschin C. Endocrine crosstalk between skeletal muscle and the brain. Front Neurol. 2018;9:698 This comprehensive narrative review discusses an important field of research examining the biological communication between skeletal muscle and brain. The authors summarize the relationship between myokines, hormones produced by contracting skeletal muscle, and key biological processes involved with optimal brain health.

    PubMed  PubMed Central  Google Scholar 

  85. Aguiar LT, Nadeau S, Martins JC, Teixeira-Salmela LF, Britto RR, Faria CDC M Efficacy of interventions aimed at improving physical activity in individuals with stroke: a systematic review, Disabil Rehabil, pp. 1–16, 2018.

  86. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet. 2015;386(9988):46–55.

  87. Kramer SF, Cumming T, Bernhardt J, Johnson L. The energy cost of steady state physical activity in acute stroke. J Stroke Cerebrovasc Dis. 2018;27(4):1047–54.

    PubMed  Google Scholar 

  88. Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med. 2015;162(2):123–32.

    PubMed  Google Scholar 

  89. Barrett M, Snow JC, Kirkland MC, Kelly LP, Gehue M, Downer MB, et al. Excessive sedentary time during in-patient stroke rehabilitation. Top Stroke Rehabil. 2018;25(5):366–74.

    PubMed  Google Scholar 

  90. Ezeugwu VE, Manns PJ. Sleep duration, sedentary behavior, physical activity, and quality of life after inpatient stroke rehabilitation. J Stroke Cerebrovasc Dis. 2017;26(9):2004–12.

    PubMed  Google Scholar 

  91. English C, Manns PJ, Tucak C, Bernhardt J. Physical activity and sedentary behaviors in people with stroke living in the community: a systematic review. Phys Ther. 2014;94(2):185–96.

    PubMed  Google Scholar 

  92. Ezeugwu VE, Manns PJ. Using intervention mapping to develop and implement a home-based sedentary behavior change intervention after stroke. Transl Behav Med. 2018.

Download references

Author information

Authors and Affiliations

  1. The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia

    Sharon Flora Kramer & Amy Brodtmann

  2. NHMRC Centre of Research Excellence Stroke Rehabilitation & Brain Recovery, Callaghan, Australia

    Sharon Flora Kramer

  3. Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia

    Stanley Hughwa Hung

  4. Melbourne Dementia Research Centre, University of Melbourne, Melbourne, Australia

    Amy Brodtmann

Authors
  1. Sharon Flora Kramer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stanley Hughwa Hung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amy Brodtmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sharon Flora Kramer.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Stroke

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kramer, S.F., Hung, S.H. & Brodtmann, A. The Impact of Physical Activity Before and After Stroke on Stroke Risk and Recovery: a Narrative Review. Curr Neurol Neurosci Rep 19, 28 (2019). https://doi.org/10.1007/s11910-019-0949-4

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11910-019-0949-4

Keywords

Search

Navigation