No sex difference in the association of pre-stroke physical activity with functional independence after ischemic stroke

Whether physical activity is associated with functional outcomes from ischemic stroke remains poorly understood. We aimed to explore the association of pre-stroke physical activity and functional outcomes in patients with acute ischemic stroke according to sex. Pre-stroke physical activity was assessed using a four-level questionnaire named Saltin-Grimby Physical Activity Level Scale (SGPALS). Our primary outcome was functional independence, defined as a modified Rankin Scale (mRS) score of 0-2 three months after stroke onset. The secondary outcome was the shift in the mRS score at 3 and 6 months. A prospective cohort study design was used to estimate the multivariable-adjusted odds of functional independence with pre-stroke physical activity. We analyzed 257 men and 142 women participants, including 230 physically inactive and 169 active ones in the final analysis. Physical active participants were at a higher odds of achieving functional independence at 3 months (adjusted OR 4.14, 95% CI 2.35-7.31; adjusted common odds ratio (cOR) 2.38, 95% CI 1.60-3.56). When stratified by sex adjusted point estimates from logistic regression models indicated that pre-stroke physical activity was significantly associated with 3-month functional independence in both men (adjusted OR 4.75, 95%CI 2.23-10.09; adjusted cOR 2.70, 95% CI 1.63-4.51) and women (adjusted OR 3.64, 95% CI 1.44-9.18; adjusted cOR 2.10, 95% CI 1.01-4.43). This study showed an association between physical activity and functional independence 3 months after ischemic stroke. Moreover, no indication of sex difference in this association were observed.