Stroke Research and Treatment最新文献

{"title":"Incidence and Risk Factors of Postcontrast Acute Kidney Injury in Patients with Acute Ischemic Stroke.","authors":"Sirichai Chusiri,&nbsp;Aurauma Chutinet,&nbsp;Nijasri Charnnarong Suwanwela,&nbsp;Chankit Puttilerpong","doi":"10.1155/2020/7182826","DOIUrl":"https://doi.org/10.1155/2020/7182826","url":null,"abstract":"<p><strong>Background: </strong>Multimodal computed tomography (CT) guides decision-making regarding use of thrombolytic agents in acute ischemic stroke patients. However, postcontrast acute kidney injury (PC-AKI) is a potential adverse effect of the contrast media used, which may require hemodialysis and cause a longer hospital stay. The incidence and risk factors of PC-AKI in acute ischemic stroke patients, particularly in Thailand, remain unclear. <i>Goal</i>. We aimed at determining the incidence and risk factors of PC-AKI in patients with acute ischemic stroke undergoing multimodal CT.</p><p><strong>Methods: </strong>We conducted a retrospective review of Thai acute ischemic stroke patients admitted to the King Chulalongkorn Memorial Hospital between January 2014 and December 2017 who received multimodal CT and thrombolytic treatment with alteplase.</p><p><strong>Result: </strong>Overall, 109 patients were included for analysis; eight patients (7.3%) developed PC-AKI. Estimated glomerular filtration rate (eGFR) ≤ 30 mL/min and mechanical thrombectomy were risk factors significantly associated with PC-AKI.</p><p><strong>Conclusion: </strong>The incidence of PC-AKI in a real practice setting did not differ from previous reports. Two factors were associated with PC-AKI, eGFR ≤ 30 mL/min and mechanical thrombectomy. Patients without these risk factors may not need to wait for the results of renal function testing prior to multimodal CT.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2020 ","pages":"7182826"},"PeriodicalIF":1.5,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7182826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37851362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Efficacy to Engage in Physical Exercise and Walking Ability Best Predicted Exercise Adherence after Stroke.","authors":"Lívia C G Caetano, Bruna D Pacheco, Giane A R Samora, Luci F Teixeira-Salmela, Aline A Scianni","doi":"10.1155/2020/2957623","DOIUrl":"10.1155/2020/2957623","url":null,"abstract":"<p><strong>Aim: </strong>To describe exercise preferences and to investigate the contribution of exercise preferences, walking ability, and current levels of physical activity in predicting exercise adherence in individuals with chronic stroke.</p><p><strong>Methods: </strong>For this exploratory study, exercise adherence was measured using the first question of the first section of the Exercise Preference Questionnaire (stroke)-Brazil (EPQ (stroke)-Brazil). Nine independent variables were included as potential predictors of exercise adherence: the seven factors of the EPQ (stroke)-Brazil, walking speed, and level of physical activity.</p><p><strong>Results: </strong>Participated 93 individuals with stroke, who had a mean age of 62 (SD 12) years and a mean time since the onset of the stroke of 58 (SD 67) months. The most preferable exercise was walking. Logistic regression analysis revealed that self-efficacy to engage in physical exercise and walking ability predicted and explained 80% of the variance in exercise adherence.</p><p><strong>Conclusion: </strong>The findings showed that feeling able to perform physical exercise and having higher walking ability predicted higher exercise adherences in individuals with chronic stroke. The knowledge of potential contributors to exercise adherence may help in designing exercise programs for individuals with stroke.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2020 ","pages":"2957623"},"PeriodicalIF":1.5,"publicationDate":"2020-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37752055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Hospital Admission for Stroke Is Characterised by Inactivity","authors":"R. Sheedy, S. Kramer, L. Johnson, N. Shields, L. Churilov, D. Cadilhac, J. Bernhardt","doi":"10.1155/2020/5879295","DOIUrl":"https://doi.org/10.1155/2020/5879295","url":null,"abstract":"Background. Measuring physical activity behaviours of stroke survivors in the inpatient setting is challenging. Authors of observational studies of early poststroke report that stroke survivors are “inactive and alone”. Using activity monitoring devices may help refine clinical practice and inform therapeutic activity targets. Aim. To measure the physical activity behaviour of stroke survivors during acute inpatient hospitalisation. We hypothesized that greater levels of inactivity would be positively associated with stroke severity and age. Method. Using a cross-sectional study design, consecutive stroke patients admitted to an acute stroke unit (Geelong, Australia) and recruited within 48 hours of admission had their physical activity recorded using an ActivPAL™ accelerometer device over a minimum of 3 days. Activity was categorised as time spent inactive (lying or sitting), standing, or stepping. The number of steps per day was recorded. Demographic and ActivPal™ data are described. Results. Seventy-eight stroke survivors were recruited of whom 54 had complete data for 3 days, all starting within 2 days poststroke. Of the 54 participants, 32 had a mild stroke, 17 moderate, and five severe stroke. Nine were able to walk independently at admission. The median age was 82.5 years (interquartile range (IQR) 74-86), 26 were female. On average, during their inpatient stay, participants spent a median of 98% of their admission inactive. A median of 18 minutes per day was spent standing and less than a minute per day was spent walking amounting to a median of 169 steps taken per day. Conclusion. The ActivePal™ device was feasible to use in an acute stroke setting. We observed high levels of inactivity in the first days post-stroke, highlighting the ongoing challenge of promoting activity in the acute stroke period. To our knowledge, this is the largest study to provide objective data on time spent upright, walking, and sedentary using accelerometer data in an acute stroke setting.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"22 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2020-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79989155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Predictors of Outcome in Spontaneous Intracerebral Hemorrhage from a Tertiary Care Centre in South India.","authors":"Ajay Hegde, Girish Menon, Vinod Kumar, G Lakshmi Prasad, Lakshman I Kongwad, Rajesh Nair, Raghavendra Nayak","doi":"10.1155/2020/2192709","DOIUrl":"10.1155/2020/2192709","url":null,"abstract":"<p><p><i>Background.</i> This article attempts to evaluate the clinical profile and outcome determinants following hypertensive SICH in a South Indian population. The study represents the largest series of SICH reported from a single centre in India. <i>Materials and Methods.</i> Prospective data collection and analysis of patients with SICH admitted to our centre between 1^st January 2015 and 31^st December 2018. The variables analysed include: age, sex, comorbidities, Glasgow coma score (GCS) on admission, radiological features, treatment modality, and outcome at three months. Modified Rankin score (mRS) was used to assess the outcome at discharge and three months. <i>Results.</i> Our study group of 905 patients included 638 males and 267 females and the mean age at presentation was 58.10 ± 12.76 years. The study group included 523 patients (57.8%) previously diagnosed hypertensive, of whom 36.3% (<i>n</i> = 190) were on irregular medication. The most frequent locations of hematoma were basal ganglia (478), thalamus (202), lobar (106), cerebellar (61), brainstem (31), and primary intraventricular haemorrhage (27). Secondary intraventricular extension was seen in 425 (47%) patients on admission. The mean volume of the clot on admission was 23.45 ± 19.79 ml, and clot progression was seen in only 46 (5.08%) cases. Surgical evacuation through craniotomy was done in 147 (16.8%) patients, and external ventricular drainage (EVD) was placed in 56 (6.2%) patients. Overall 3-month mortality was 30.1% (266 patients). On the last follow up a favorable outcome (mRS 0-3) was observed in 412 (45.53%) patients and a poor outcome (mRS 4-5) in 207 patients (22.87%). Independent predictors of mortality are Age >70 (<i>p</i> = <0.001, OR 4.806, 95% CI 3.064-7.54), admission GCS <8 (<i>p</i> = <0.001, OR7.684, 95% CI 5.055#x2013;11.68), and Hematoma volume >30 ml (<i>p</i> = <0.001, OR 2.45, 95% CI 1.626-3.691). Intraventricular haemorrhage was an additional poor outcome predictor (<i>p</i> < 0.015, CI 1.105-2.585). Surgical evacuation reduced mortality in the group, but morbidity rates remained the same. <i>Conclusions.</i> SICH predominantly affects a younger population in India in comparison to the Western society. Elderly age, poor GCS on admission, clot volume above 30 ml and intraventricular extension remain the most consistent predictors of death and poor outcome. Further studies are needed to assess the risk of SICH among hypertensive patients and to prognosticate the outcome after SICH using novel predictors, including biomarkers.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2020 ","pages":"2192709"},"PeriodicalIF":1.5,"publicationDate":"2020-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37937356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and Outcomes of Younger Adults with Embolic Stroke of Undetermined Source (ESUS): A Retrospective Study.","authors":"Ali M Al Khathaami,&nbsp;Bayan Al Bdah,&nbsp;Abdulmjeed Alnosair,&nbsp;Abdulkarim Alturki,&nbsp;Rayan Alrebdi,&nbsp;Shorug Alwayili,&nbsp;Sulaiman Alhamzah,&nbsp;Fahad A M AlKhathaami,&nbsp;Nasser Alotaibi","doi":"10.1155/2019/4360787","DOIUrl":"https://doi.org/10.1155/2019/4360787","url":null,"abstract":"<p><strong>Introduction: </strong>Embolic stroke of undetermined source (ESUS) in younger adults may have different risk factors compared with ESUS in elderly, and the approach to ESUS in young adults may require new therapies. We aimed to investigate the characteristics and outcomes in younger adults with ESUS at a single centre in Saudi Arabia.</p><p><strong>Patients and methods: </strong>A retrospective study was conducted using the medical records of younger adults with ESUS according to the criteria of the Cryptogenic Stroke/ESUS International Working Group. Younger adults (aged ≤50 years) with ESUS were compared with older patients, on admission and discharge from hospital, using the modified Rankin scale (mRS) and the National Institute of Health Stroke Scale (NIHSS).</p><p><strong>Results: </strong>Among 147 patients with ESUS, 39 (26.5%) were younger adults. Younger adults compared with older adults with ESUS had fewer vascular risk factors, including lower rates of hypertension (43.6% vs. 70.3%; <i>P</i> = 0.004), diabetes (35.9% vs. 57.4%; <i>P</i> = 0.03), and dyslipidaemia (12.8% vs. 28.7%; <i>P</i> = 0.05). There was no significant difference in poor outcome at discharge (defined as mRS > 2), which was observed in 17.9% of younger adults and 28.7% of older adults. Further, there were no significant differences in stroke severity at discharge (NIHSS score ≤5) or median length of stay.</p><p><strong>Discussion: </strong>Although the outcomes of ESUS do not differ between younger and older patients, younger patients have fewer identified risk factors.</p><p><strong>Conclusion: </strong>This study showed that 26.5% of patients with ESUS were aged ≤50  years. Although younger adults with ESUS had fewer risk factors, there were no significant differences in neurologic disability or mortality at discharge, stroke severity, or median length of stay.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2019 ","pages":"4360787"},"PeriodicalIF":1.5,"publicationDate":"2019-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/4360787","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37499215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less Experienced Telestroke Consultants Are More Likely to Go On-Camera, but Less Likely to Give tPA","authors":"A. D. de Havenon, Lee S Chung, Jaleen Smith, Kirby Taylor, J. Majersik, N. Chauhan","doi":"10.1155/2019/1059369","DOIUrl":"https://doi.org/10.1155/2019/1059369","url":null,"abstract":"Background Stroke telemedicine (telestroke) increases tPA availability and administration. However, the effective use of telestroke requires training, which is not a standard component of vascular neurology training. As a result, many providers learn telestroke skills “on the job” after finishing their training. Aims We sought to explore if providers with more telestroke experience would be more efficient in the utilization of telemedicine, compared to providers with less experience. Methods We prospectively collected data on telestrokes between July 2014 and July 2017 at a Comprehensive Stroke Center. Telestrokes are initiated on the telephone and typically, but not always, followed by an on-camera consult. Decision to do a phone-only versus on-camera consult is at the provider's discretion. Results There were 1,029 telestrokes, of which 807 were on-camera (74%). Of the 8 telestroke providers, 4 had less experience, having just finished stroke fellowship, and 4 had more experience (mean = 7.8 years of telestroke experience at the beginning of the study). Providers with less experience were more likely to go on camera than providers with more experience (79% vs. 67% of consults, p = 0.021), but were less likely to give tPA when on-camera (25% vs. 33%, p = 0.023). The absolute rate of tPA administration, combining phone and camera administration, or the frequency of technical difficulties were not different. Conclusions Telestroke consultants with less experience do not triage as many cases by phone and are less likely to administer tPA on-camera, suggesting their use of telemedicine is not optimized. This supports the introduction of telestroke didactics during vascular neurology training.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"4 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80700751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prevalence of Dyslipidemia and Hyperglycemia among Stroke Patients: Preliminary Findings","authors":"Iyad Ali, Mahmoud Abuissa, A. Alawneh, Omar Subeh, Ahmad Abu Sneineh, Sabreen Mousa, Israa' Deeb, Hiba Rayyan","doi":"10.1155/2019/8194960","DOIUrl":"https://doi.org/10.1155/2019/8194960","url":null,"abstract":"Background/Aim Stroke or cerebrovascular accident is defined as sudden or sub acute onset of focal neurologic deficit, caused by the interruption of blood flow to parts of the brain. In this study, we aimed to investigate the prevalence of dyslipidemia and hyperglycemia among stroke patients in Palestine. Materials and Methods A total of 70 patients with stroke were included in a cross-sectional study between November 2017 and February 2018. Stroke patients were diagnosed based on a CT scan reviewed by a neurologist. Fasting venous blood samples were collected to measure the lipid profile (cholesterol, low-density lipoproteins (LDL), triacylglycerol (TAG), high-density lipoproteins (HDL)), fasting blood glucose (FBG), and glycosylated hemoglobin (HbA1c) levels. An interview-based questionnaire, included background data, past medical history, family history, and other risk factors for stroke, was filled for each patient. Results Based on our results, 28.57% of patients had high LDL, 17.1% had high cholesterol, 15.7% had high TAG and 61.3% had low HDL. About half of the patients (51.4%) had abnormal HbA1c and abnormal FBG (52.8%). The majority (67.1%) of patients were males, whereas, 11% of patients were obese (BMI of more than 30 kg/m2) and 51.4% were smokers. Regarding the family history of diseases, 81% of patients had a family history of hypertension, 50% had a family history of stroke, and 58% had a family history of diabetes mellitus. Conclusion Male gender and smoking were most likely to increase the risk of stroke. Risk factors like low HDL, high LDL, high FBG, high HbA1c, and hypertension contribute substantially to the incidence of stroke. A family history of stroke, hypertension and diabetes were significant risk factors for stroke.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"67 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79544143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Failure Is Not Associated with a Poor Outcome after Mechanical Thrombectomy in Large Vessel Occlusion of Cerebral Arteries","authors":"Marlena Schnieder, Anneki von Glasenapp, A. Hesse, M. Psychogios, M. Bähr, G. Hasenfuss, M. R. Schroeter, J. Liman","doi":"10.1155/2019/4695414","DOIUrl":"https://doi.org/10.1155/2019/4695414","url":null,"abstract":"The impact of heart failure on outcome in stroke patients is not fully understood. There is evidence for an increased mortality and morbidity, but it remains uncertain whether thrombectomy in patients with large vessel occlusion (LVO) in the anterior circulation is less effective in patients with heart failure compared to patients without. Retrospectively, we analyzed echocardiographic data of all patients in our stroke database, who underwent mechanical thrombectomy (n=668) for the presence of heart failure. Furthermore, we collected baseline characteristics and neurological and neuroradiological parameters. In the analysis, 373 of the 668 patients of our stroke database underwent echocardiography. Of these 373 patients, 90 patients (24%) suffered from heart failure with reduced left ventricular ejection fraction measured by echocardiography according to the current guidelines. After adjustment for age, the Alberta stroke program early CT score (ASPECTS), and time from symptom onset to recanalization, the analysis revealed that thrombectomy in patients with heart failure and LVO is not associated with less favorable outcome measured by the modified Rankin Scale after 90 days (3 (0-6) vs. 3 (1-5); p=0.380). Moreover, we could not find a significant difference in mortality compared to patients without heart failure (11.0% vs. 7.4%; p=0.313).","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"154 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78001752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Preliminary Validation of a Stroke Physical Activity Questionnaire","authors":"Thunyakamon Phusuttatam, Jittima Saengsuwan, P. Kittipanya-ngam","doi":"10.1155/2019/6764834","DOIUrl":"https://doi.org/10.1155/2019/6764834","url":null,"abstract":"Objective The aim of the current study was to develop and then to determine preliminary validity of a physical activity questionnaire specifically designed for ambulatory, chronic stroke patients. Methods This cross-sectional study recruited 92 chronic stroke patients. In Phase I, the SPAQ was developed and its content validity index (CVI) determined. In Phase II, we examined (1) the concurrent validity of SPAQ vs. the International Physical Activity Questionnaire-Short Form (IPAQ-SF); (2) the convergent validity of SPAQ vs. the Functional Ambulation Category (FAC), vs. the six-minute walk test (6-MWT), vs. the timed up and go test (TUGT), vs. the Motricity Index, vs. the National Institutes of Health Stroke Scale (NIHSS), and vs. the Modified Rankin Scale (MRS); and (3) the discriminant validity of the SPAQ vs. the Montreal Cognitive Assessment (MoCA). The concurrent validity and convergent and divergent validity were analysed using Spearman's rank correlation coefficient. The agreement between the SPAQ and IPAQ-SF was assessed using the Kappa statistic. Results The SPAQ has 12 items in 3 main components which covers low (7 items), moderate (3 items), and vigorous (2 items) physical activity. The SPAQ had a CVI of 0.93. Spearman's correlation coefficient (rs) for SPAQ vs. IPAQ-SF was 0.53 (p < 0.001). The SPAQ yielded substantial agreement with the IPAQ-SF (Kappa = 0.65). For convergent validity, the SPAQ had a moderate correlation with the 6-MWT, MI, NIHSS, FAC, TUGT, and MRS (p < 0.05). For discriminant validity, the SPAQ was not correlated with the MoCA (rs = 0.061, p = 0.68). Conclusion The SPAQ can be used to practically assess physical activity in chronic stroke patients, and it has acceptable psychometric properties which are comparable to other standard physical activity questionnaires. Future work should determine the validity of the SPAQ using an objective device such as an accelerometer.","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"274 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83041660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leisure Time Physical Activity Reduces the Risk for Stroke in Adults: A Reanalysis of a Meta-Analysis Using the Inverse-Heterogeneity Model.","authors":"George A Kelley,&nbsp;Kristi S Kelley","doi":"10.1155/2019/8264502","DOIUrl":"https://doi.org/10.1155/2019/8264502","url":null,"abstract":"<p><strong>Objective: </strong>Apply more robust and additional analyses to a previous meta-analysis that reported statistically significant associations between leisure time physical activity (LTPA) and stroke.</p><p><strong>Methods: </strong>A reanalysis of a previous meta-analysis that included nine prospective cohort studies representing 269,594 men and women 25-84 years of age and in which the association between LTPA and incident stroke was examined. Follow-up periods ranged from 7.7 to 32.0 years. Relative risks (RR) from each study were pooled using the inverse-heterogeneity model. Heterogeneity was examined using the Q statistic, inconsistency using <i>I</i> ², and small-study effects using Doi plots and the LFK index. Influence and cumulative meta-analysis were also conducted.</p><p><strong>Results: </strong>Using low LTPA as the reference, moderate LTPA was associated with a statistically significant reduction in the risk for stroke in men (RR = 0.79, 95% CI = 0.65 to 0.95) and a trend in women (RR = 0.88, 95% CI = 0.78 to 1.0). High LTPA was associated with a statistically significant reduction in the risk for stroke in both men (RR = 0.72, 95% CI = 0.60 to 0.86) and women (RR = 0.78, 95% CI = 0.66 to 0.92). No statistically significant heterogeneity was observed and inconsistency was low. However, potential small-study effects were observed. With each study deleted once, results remained statistically significant. Cumulative meta-analysis demonstrated stability in results since at least 2005.</p><p><strong>Conclusions: </strong>Leisure time physical activity is associated with a reduced risk of stroke in both men and women. However, the small-study effects observed suggest the possibility that results may be exaggerated.</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2019 ","pages":"8264502"},"PeriodicalIF":1.5,"publicationDate":"2019-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2019/8264502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37395820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}