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Daily Walks May Decrease Severity of First Time Strokes

Analysis by Dr. Joseph Mercola Fact Checked

daily walks for stroke

Story at-a-glance -

  • Data extracted from two Swedish stroke registries involving 925 adult stroke survivors, with an average age of 73, associated weekly exercise with a reduction in stroke severity
  • While noting the positive effects of exercise on strokes, the researchers observed that neither diabetes, the patient’s sex and smoking, nor the use of blood pressure medication or statin drugs, influenced stroke severity
  • When it comes to safeguarding your cardiovascular health, regular exercise provides many benefits and the current study suggests even low to moderate physical activity can be beneficial for stroke prevention
  • An observational study conducted in the U.S. and Uganda suggests Americans tend to walk faster with a partner and especially when accompanied by children, whereas Ugandans slow down

A new study based on Swedish stroke registries suggests adults who participate in light to moderate physical activity may have less severe strokes than their physically inactive peers. The researchers recommended at least four hours of walking or two to three hours of swimming a week as a potential means of reducing stroke severity.

Since it's rare to find a health condition that cannot be improved by exercise, these findings are not surprising. Especially when it comes to safeguarding your cardiovascular health, regular exercise provides numerous benefits. Let's take a closer look at how walking can boost your overall health and well-being, particularly as it relates to strokes.

Research Associates Exercise With a Reduction in Stroke Severity

The September 2018 edition of the journal Neurology1 highlights research about the potential relationship between physical activity and strokes. Data extracted from two Swedish stroke registries, involving 925 adult stroke survivors with an average age of 73 (range 20 to 104), associated weekly exercise with a reduction in stroke severity.

Notably, the data on exercise habits was self-reported and gathered only after the participants had suffered a stroke — two potentially limiting factors for the research. After all, a person's memory and cognition may be negatively affected by even a mild stroke and those effects would likely be amplified in cases of a severe stroke.

Researchers noted that 80 percent of the study participants had suffered a mild stroke and nearly 94 percent had had an ischemic stroke. About the study, Dr. Katharina Sunnerhagen, professor and chief physician in the department of clinical neuroscience at the University of Gothenburg in Sweden, stated:2

"Stroke is a major cause of serious disability, so finding ways to prevent stroke or reduce the disability caused by stroke [is] important. While exercise benefits health in many ways, our research suggests that even simply getting in a small amount of physical activity each week may have a big impact later by possibly reducing the severity of a stroke."

With respect to classifying their prestroke physical activity, participants were asked after the fact about their movement and exercise habits during leisure time before they had the stroke. Sunnerhagen and her team estimated the average amount of physical activity for each participant based on questions related to the duration and intensity of exercise performed. Below are some additional facts about the study: 3

  • Fifty-two percent of the participants said they were not physically active before their stroke; 42 percent had engaged in light activity; and 6 percent were involved in moderate physical activity
  • Light physical activity was defined as walking at least four hours a week
  • Moderate physical activity was defined as engaging in more intense forms of exercise such as brisk walking, running or swimming for two to three hours per week
  • Relatives were asked to confirm the exercise levels reported by stroke survivors, when needed
  • Neither diabetes, the patient's sex and smoking, nor the use of blood pressure medication or statin drugs, influenced stroke severity

Based on the data, the researchers noted people who engaged in light to moderate physical activity before their stroke were twice as likely to have a mild stroke when compared to people who were physically inactive. Based on the outcomes, light and moderate physical activity were found to be equally beneficial, which means getting any kind of exercise is helpful to reduce stroke severity.

"There is a growing body of evidence that [suggests] physical activity may have a protective effect on the brain," says Sunnerhagen. "Further research is needed to better understand just how physical activity influences the severity of a stroke."4 For now, she recommends physical inactivity be monitored as a possible risk factor for severe stroke.

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Regular Exercise Is One of the Keys to Optimal Health

For strokes and nearly every other health condition, getting even a little exercise is better than none. In fact, it will be impossible for you to achieve optimal health unless you exercise on a regular basis. (Eating a healthy diet and getting sufficient sleep are two other important factors to ensure your well-being.)

In an editorial accompanying the Swedish research, Nicole Spartano, Ph.D., research assistant professor of medicine in endocrinology, diabetes, nutrition and weight management at Boston University School of Medicine, and Julie Bernhardt, Ph.D., physiotherapist and clinical head of the stroke division at the Florey Institute of Neuroscience and Mental Health at the University of Melbourne in Australia, underscore the strong epidemiologic evidence that supports physical activity's effectiveness to prevent stroke. They stated:5

"Physical activity has a favorable effect on vascular risk factors such as hypertension, diabetes mellitus, obesity, lipid profile and psychosocial factors, each known to affect stroke risk.

A growing body of literature also suggests that even among individuals who have [had a] stroke, those who led a physically active lifestyle tended to have less severe strokes. Furthermore, experimental research in animal models supports the value of exercise before and after stroke as a modifier of poststroke outcome."

On a weekly basis, the American Heart Association (AHA)6 recommends you get 150 minutes of moderate exercise or 75 minutes of vigorous exercise, or a combination of both types. For moderate exercise, all you need to do is walk for 30 minutes a day, five days a week. If you prefer vigorous activities like biking or running, you should target at least 25 minutes a day, three days a week.

"Even quite light physical activity — such as walking for at least half an hour a day — enhances the chances of having a milder stroke compared to inactive persons," Sunnerhagen told MedPage Today.7

The AHA also recommends you add moderate- to high-intensity muscle strengthening activity at least two days a week. One of my favorite types of high-intensity exercise is the four-minute Nitric Oxide Dump workout. For the best results, I suggest you perform the routine every day, at least three times a day. Once you try it, you're likely to make it part of your daily exercise regimen.

Keep in mind that, generally speaking, the more vigorous the activity, the less time needed to get results. So with high-intensity activities like high-intensity interval training (HIIT), you can achieve significant health benefits in just minutes a week.

Beyond increasing your frequency of exercise, it's imperative you also take a closer look at how much time you spend sitting. A sedentary lifestyle is fast becoming a significant risk factor for chronic disease. With respect to the current study, Dr. Robert Glatter from the department of emergency medicine at Lenox Hill Hospital in New York City, commented in Forbes:8

"Exercise and staying active is crucial as we age. The study, while limited due to the bias of self-reported data, still offers sound advice. Engaging in exercise may offer an extra benefit as we age, reducing the chances of having a debilitating stroke that could leave us paralyzed or reduce [our] cognitive abilities.

What's clear from a growing body of medical literature is that our principal enemy is physical inactivity. We have to fight the urge to sit, and get up and become more active throughout the day and our lives."

Do You Know the Risk Factors for Stroke?

Glatter also called out modifiable factors known to influence your stroke risk. Left unchecked, he noted the following conditions can increase your risk of stroke:9

  • Atrial fibrillation (AFib)
  • Cholesterol (Note: It's important to balance your levels, not eliminate cholesterol from your diet)
  • Diabetes
  • High blood pressure

With the exception of AFib, Glatter notes the other factors also have been shown to increase your risk of coronary artery disease, making you susceptible to a heart attack.10 In case you are unfamiliar with AFib, it is an irregular or quivering heartbeat (also known as an arrhythmia) that can lead to blood clots, heart failure and stroke.

The AHA says11 when left unchecked AFib doubles your risk of heart-related deaths and is associated with a fivefold increased risk for stroke. They also note some 2.7 million Americans are affected by AFib. If you are dealing with AFib or one or more of the other risk factors, it's important you face the reality you may be more vulnerable to stroke.

Certainly, it's worth your time to dig into any potential underlying causes. For example, with respect to AFib, hyperthyroidism might be driving the arrhythmia. If so, treating the thyroid condition may be enough to resolve AFib. Similarly, if your high blood pressure is primarily driven by obesity, perhaps it's time to overhaul your diet. By reducing or eliminating your intake of processed foods and sugar you can get back to a healthy weight that will most likely bring your blood pressure down.

Type 2 diabetes also has been shown to be reversable through dietary and lifestyle changes. If you are prediabetic or diabetic, reducing your fructose consumption is a great first step you can take to better your health. Strive for less than 15 grams per day of fructose from whole fruit and other sources. Finally, for useful information on balancing your cholesterol levels, check out my "How to Make Sense of Your Cholesterol Levels Infographic."

Exercise Is Great for Your Brain

Spartano and Bernhardt believe exercise may help make your brain more resilient, which is something I also believe. They stated, "Physical activity induces angiogenesis, neurogenesis and synaptogenesis in the brain and likely contributes to resiliency of the brain, the brain's cognitive reserve, through these mechanisms."12

In addition, they highlighted earlier research13 suggesting low-intensity daily walking helped preserve hippocampal volume and cognitive function in older adults. Spartano and Bernhardt noted that research "provides some of the strongest evidence for the influence of physical activity on cognitive reserve."14

To me, exercise is beneficial in helping to promote mitochondrial changes that can lead to whole-body benefits. Even low-intensity exercise like walking can be a "remedy" for the declines in mitochondrial biogenesis and mitochondrial protein quality typically seen with aging.

Exercise can also promote mitochondrial biogenesis in the brain, potentially leading to a reduction or reversal of age-associated decline in cognitive function and assistance in repairing brain damage after a stroke. 15,16 The researchers who evaluated the effects of treadmill exercise on lab rats subjected to ischemia, said:17

"The results indicate that exercise can promote mitochondrial biogenesis after ischemic injury, which may serve as a novel component of exercise-induced repair mechanisms of the brain.

Understanding the molecular basis for exercise-induced neuroprotection may be beneficial in the development of therapeutic approaches for brain recovery from the ischemic injury. Based upon our findings, stimulation or enhancement of mitochondrial biogenesis may prove a novel neuroprotective strategy in the future."

Spartano and Bernhardt commented that animal studies also have demonstrated the role of exercise in promoting redundancies in your cerebrovascular system and decreasing stroke severity.18

"Maintaining an active lifestyle may help retain this collateral circulation, as well as having other protective effects on cognitive reserve that we have yet to fully understand," they noted. "A physically active person who has a stroke might, therefore, be protected." 19 The bottom line: Physical exercise is good for your brain and a potential "insurance policy" against strokes.

Cross-Cultural Study Evaluates the Dynamics of Walking

While you may not give much thought to how you walk, research published in the journal PeerJ — Life & Environment20 suggests there are unique aspects of this common physical activity that vary from country to country. After observing hundreds of walkers in the Northwestern U.S. and in Central Uganda, researchers from Seattle Pacific University assert people walk differently depending on where they live and with whom they walk. In Seattle, Washington, they noted:

  • People sped up when they walked with others
  • Men hurried when walking with other men
  • Both men and women walked, on average, about 20 percent faster when walking with children

In Mukono, Uganda, they observed:

  • People walked more quickly when they were alone; the pace of solo Ugandan walkers averaged about 11 percent faster than lone walkers in Seattle
  • Walkers in groups were slower
  • Both men and women walked, on average, about 16 percent slower when accompanied by children, whether the kids were carried or walked on their own

Given the observational nature of the study — the researchers did not interview any of the participants — the motivating factors of the walkers remains unknown. That said, lead researcher Cara Wall-Scheffler, Ph.D., biology professor at Seattle Pacific University, offers a hypothesis.

She stated, "It seems plausible that people in Uganda use their time when they are walking in groups to socialize and bond."21 That may explain why they walk slowly with others, she says.

Wall-Scheffler and her undergraduate researcher Leah Bouterse observed the pace of group walking in the U.S. was quite different from what they saw in Uganda. "If the kids are with you, the walking seems to become more task-oriented [in the U.S.]," Wall-Scheffler said. "You have to get things done. You hurry."22

Whether you choose to walk in a group or alone, walking is an easy exercise you can engage in nearly anywhere — and, as noted in the video above, it changes your body in positive ways. Now that you know even low-intensity walking can potentially help protect your brain from strokes, or at least reduce the stroke intensity, it's time to lace up your shoes and get moving.