That fitness allowed me to go on a an extended wilderness canoe trip 3 years post-stroke. In 2009 this was my 'vacation'. A 21 day canoe trip on the Eagle, Bell and Porcupine rivers in the Yukon and Alaska with Wilderness Inquiry. I wouldn't call it a vacation because we paddled every day and I was quite fatigued every day. I ended up being the only disabled person on the trip.
Because of my fitness and my superior balance I take risks no survivor should try to follow.
So my read on this research is that YOUR pretreatment for stroke requires you to be very physically fit. This allows your doctor to not have to do one goddamn thing about your recovery after your stroke. Like maybe solving these 5 causes of neuronal cascade of death in the first week
Research has suggested that people who have higher levels of physical activity before a stroke have better outcomes after the stroke has occurred, but scientists have yet to understand the underlying mechanisms.1
“In the present study we have observed that a high level of self-reported physical activity prior to stroke was associated with greater VEGF expression in the first days after ischemic stroke. Likewise, this increment in VEGF levels was independently associated with a reduction in final infarct volume and with improvement of functional outcome at 3 months,” wrote first author Elena Lopez-Cancio, MD, PhD, of the Universidad Autónoma Barcelona (UAB) (Barcelona, Spain), and colleagues.
The study was part of the AFRICA (Prestroke Physical Activity and Functional Recovery in patients with Ischemic stroke and Arterial Occlusion) study. Participants were included if they had experienced an acute ischemic event in the anterior large artery, and were admitted to a single tertiary care stroke center in Barcelona, Spain between June 2008 and January 2011.
Using a validated questionnaire, participants self-reported their physical activity in the past week before the stroke. They also provided blood samples for evaluation of circulating VEGF, granulocyte colony-stimulating factor (G-CSF), and brain-derived neurotrophic factor (BDNF). Levels of these angiogenic and neurogenic factors were evaluated upon admission, at 7 days, and three months post-stroke.
The analysis included 83 patients, with a mean age of 69.6 years.
• VEGF increased from baseline to day 7
• Higher serum VEGF at day 7 was independently linked to smaller infarct volume at 30 days, and improved functional outcome at 3 months
• G-CSF and BDNF were not linked to prestroke physical activity or stroke outcomes
The authors provided several explanations for these results. Past studies have suggested that physical activity may increase VEGF expression. In turn, animal studies have suggested that VEGF may play a role in neuroprotection, neurogenesis, nitric oxide-induced angiogenesis and repair of the postischemic brain. Animals studies have also suggested that VEGF expression in parts of the brain increases after an ischemic event, and this increase has been linked to smaller infarct volume.
If VEGF is neuroprotective, administering it after stroke may improve outcomes, they suggested. Unfortunately, studies that have evaluated post-stroke VEGF delivery show positive but also negative effects, including blood-brain barrier leakage and brain edema. The authors propose that physical activity may be a safe way to increase VEGF production, rather than delivering exogenous VEGF.
“Although there are probably more molecular mechanisms by which physical activity exerts its beneficial effects in stroke outcomes, our observation regarding the potential role of VEGF is plausible and in line with previous experimental studies. Further research in this field is needed,” they concluded.
• A study in Spain found that VEGF increases from baseline to day 7 in patients with ischemic stroke.
• Patients with higher levels of pre-stroke physical activity had greater increases in VEGF than those with lower levels of pre-stroke physical activity.
• Higher increases in VEGF and higher levels of pre-stroke activity were linked to improved functional outcomes at three months, and smaller infarct size at 30 days.
• Physical activity may be one way to increase synthesis of VEGF, which may be neuroprotective in stroke.
• Further studies are needed.
This study was partially supported by the Instituto de Salud Carlos III, the Spanish Research Network on Cerebrovascular Diseases, and the European Union program FEDER. Drs. Campos and Sobrino have received research contracts from Miguel Servet Program of Instituto de Salud Carlos III. Dr. López-Cancio has received a research contract from Juan Rodés program of Instituto de Salud Carlos III.
2. López-Cancio E, et al. Reported prestroke physical activity is associated with vascular endothelial growth factor expression and good outcomes after stroke. J Stroke Cerebrovasc Dis. 2016 Oct 28.