The Mystery of Southeast “Stroke Belt”
First time published on 2006 – Last time edited on 17 February 2009
– Foreword –
Everywhere in the world people are afraid from stroke and the majority of them are afraid even just thinking about stroke. Living in certain geographical areas where it is known that in average strokes occur more often than other area is one extra burden.
Understanding why in some geographical areas incidences of stroke are more common than in others will open the way to understand the real cause of stroke and will enable us to design an effective and efficient treatment for stroke survivors.
Understanding what make us more prone to stroke will offer an explanation of how to make us resistant or at least less vulnerable to stroke.
I am sure that everyone will be able to do something about the prevention of stroke without changing the place of residency. Adequate vitamin D intake is a great preventative against experiencing a stroke.
I hope this article will not only bring positive attitude to everyone but as well give knowledge towards stroke forever and for everyone it doesn’t mater if he/she is a stroke survivor or he/she lives in a particular geographical area.
Solved: The Mystery of Southeast “Stroke Belt”
(First time published on 2006 – Last time edited on 18 May 2009)
It has been known for about fifty years that the incidence of stroke is more common in the South Eastern States of the USA, an area known as the “Stroke Belt”. In the “Stroke Belt” area the incidences of ischemic and hemorrhagic strokes (and an increased risk of death from stroke) are substantially higher than in the rest of the USA. (Even the children in Stroke Belt states have an increased risk of death from stroke compared with children in other states in an extent similar to that in adults).
The “Stroke Belt” is usually defined as an 11 state region which includes; Virginia, North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana, Arkansas, Tennessee, Kentucky and Indiana. Incidence of stroke in these states is 50% higher than in the West and in the Northeast of the US, and 30% higher than in Midwest of the US and nearly twice higher than in the New York metropolitan area.
By taking a closer look on the available data we can see that not only is the “Mystery of Southeast Stroke Belt” a reality but the “Mystery of Midwest Stroke” is also a reality, because for unknown reasons, the Midwest of the country has a higher incidence of strokes than the West and Northeast of the country.
By comparing the incidence of stroke between the West and the Northeast of the country with the New York metropolitan area, we can see that the incidence of stroke is much higher in the West and Northeast than in the New York metropolitan area and because of this fact, we can call it the “Mystery of Northeast Stroke” and the Mystery of West Stroke”.
Actually any incident of stroke, it doesn’t mater if it is in the Southeast or in the Northeast of the country or anywhere in the world, it is a mystery because till this day, no one knows why some people are affected by stroke and others are not.
By comparing the incidence of stroke between different regions we can see that the geographical factors play an important role in the incidence of stroke. It leads to the conclusion that by understanding why incidence of stroke is more common in some region than others will enable us to make the first step in the attempt to understand the real cause of stroke anywhere in the world.
If we take a look on the map of the area where the Stroke Belt States are located, we can see that a significant part of their territory consists of flat surfaces of the ground (plain area). This points out that the people who live in hilly areas and in the mountain areas are less prone to strokes compared to a population that is living in a flat (plain) area.
One more contributing fact to make such a conclusion is that this stroke belt has a “buckle” (a zone within a zone) that has stroke death rates “substantially higher” than the stroke belt itself, and twice as high as the rest of the country.
Reporting in the May issue (1997) of the American Heart Association journal “Stroke”, the scientists identify the “buckle” as the coastal plain sectors of North Carolina, South Carolina and Georgia. In this 153-county area, the new study shows, stroke deaths are 2.1 times higher than the rate of the nations average among people whose ages are 35 to 54, and 1.7 times greater for people between the ages of 55 and 74.
Taking a look on the geographical map of this region it is visible that coastal plain sectors of North Carolina, South Carolina and Georgia is completely flat and as it is more distanced from the coast the area is less flat (piedmont). This shows that the population living in coastal plain areas in those three states are more prone to stroke than people who live in the piedmont and in mountain regions in the same state.
We can see that somehow the physical geographical factors are responsible for increased and decreased incidence of strokes in a particularly geographical area (coastal flat area, piedmont and mountain area) inside the Stroke Belt area.
The question why and how geographical-environmental factor is in some extent responsible for the incidence of stroke will be answered by comparing the biomechanics of everyday locomotion done in flat area to the biomechanics of everyday locomotion done in a hilly (piedmont) and a mountain area.
We are performing locomotion like walking, running and as well as the voluntary and involuntary movement of the limbs by voluntary and involuntary activity of the muscles.
The activity of the muscles is in causal relation with the neuromuscular control system’s activity.
(Every conscious physical activity consists of the mental activity, neuronal activity and the musculoskeletal system activity).
A side note: The activity of neuromuscular control system should be observed through the model of neuromuscular control centre activity and neuromuscular peripheral system activity, where the neuromuscular controls centre acting through peripheral neuromuscular system. At this time the neuromuscular control centre and neuromuscular peripheral system is unknown to neuroscience.
People who live in areas with hills and mountains are more frequently forced to incorporate a diversity of motion in their everyday locomotion because they are more often confronted with activities like walking up a hill, walking down a hill and walking diagonally up a hill and walking diagonally down a hill etc.
Any particular human locomotion is at the same time a particular motor skill activity.
The diversity of motion means the diversity of physical activity.
The diversity of physical activities is at the same time a diversity of neuromuscular control centre activity.
The maintenance or improvement of the motor skills ability means at the same time the maintenance or improvement of the neuromuscular control centre.
On the other side, the people who live in a flat-plain area do not often have the opportunity to walk down a hill or up a hill, most of their lives they walk only on flat surfaces.
Walking on a flat surface for most of the time has the consequence that the habitually gait is used to perform everyday locomotion (habitually walking pattern and habitually running pattern) to a greater extent than by people who are living in a hilly and mountainous area.
The people, who live in hills and mountain areas in general, are more often obligated to incorporate diverse physical activity in their everyday locomotion. In general, they will more often exercise their motor skills compared to the people living in flat areas.
By exercising our own motor skill ability we are at the same time exercising our own neuromuscular control centre.
(It can be said that by exercising-using our own motor skill ability we are exercising-using our own neuromuscular control centre).
The physical geography of mountainous area obligates us to use a diversity of motor skills (slowing and speeding skills, jumping skill etc) in order to perform everyday locomotion.
Diversity of motor skills is at the same time diversity of neuromuscular control centre activity.
Concerning the neuromuscular control system, the physical geography of hilly and mountain region forces an increased activity of the neuromuscular control centre and on the other side it forces an increased diversity of the neuromuscular control centre activity for the time of performing everyday locomotion.
Habitual locomotion for prolong period of time has the consequence that the musculoskeletal system is physical active but the neuromuscular control centre is under-active.
By prolonged time of inactivity or insufficient activity of the neuromuscular control centre has the consequence of its deterioration.
By prolonged time of doing physical activity mainly in a habitual way, the motor skill deteriorates. A deterioration of motor skill ability means at the same time a deterioration of neuromuscular control centre.
On a side note: the geographical environment of hilly and mountain area obligate us to do locomotion in such a way that our mind is in the present. For example when we are walking down the hill we have to take care not to fall down. And all the time by doing this activity our mind is in the present. As well as we can’t walk down the hill with habitual walking patterns. On the other side an unexpected obstacles on our way by walking or running are factors that obligate us to increase diversity of motion.
Apart from that everyday locomotion in a hilly and a mountain area forces an increased diversity of motion and increased activity of neuromuscular control centre it has a calming effect on the mind. It is excellent guardian against stress because as we are mentally involved in physical activity (entire brain is involved in physical activity) there is no space left for the stress.
Analysing and comparing the biomechanics of walking on even ground and on uneven ground shows that the daily locomotion performed in a hilly and in a mountain area to a greater extent is sufficient to maintain the optimal state of neuromuscular control centre and that the daily locomotion performed only in a flat (plain) area isn’t sufficient to maintain the neuromuscular control centre in a optimal state.
Differences between the biomechanics of locomotion performed in a mountain and a hilly area and the biomechanics of locomotion performed in a flat area explains why the people who are living in mountain regions are less prone to stroke than people who are living in a flat area.
On the other side not every flat area causes increased incidences of strokes.
Despite similar physical geography to the state located in the buckle zone, the South part of Florida has one of the lower incidences of the stroke in the US.
If we take a look at the physical geography of Florida we can see that the whole area is flat, as same as the coastal plain sectors of Georgia, South Carolina and North Carolina and this area is known as a “Buckle” of the “Stroke Belt”.
Like the people living in the coastal plain sectors of Georgia, South Carolina and North Carolina, the people who live in the south part of Florida, do not often have the opportunity to walk on uneven ground like walking up a hill and down a hill, etc.
On the other side, a few other factors are responsible for lower incidence of stroke in the southern part of Florida.
Because of the warm climate for most part of the year and sandy beaches, the population in the south part of Florida, have more opportunities to walk with bare feet.
Walking with the bare feet has the consequence of increased sensory contact between feet and the ground, and that has the consequence of providing stimulations for the peripheral nervous system (PNS).
Increased sensory contact between the body surface and environment increases peripheral nervous system activity.
The central nervous system is getting input through the periphery nervous system. Increased activity of the periphery nervous system has the consequence of increased activity of the central nervous system (CNS).
Also, because of the warm climate for most part of the year, people in the southern part of Florida are spending more time in the sea water and in swimming pools.
From a biomechanical point of view, swimming alone is one particularly important motor skill. The musculoskeletal system works slightly differently when the locomotion, like walking, running etc is performed in the water.
By swimming the musculoskeletal system is to a greater extent differently engaged to perform swimming locomotion. On the other side, by swimming the neuromuscular control centre is differently engaged than what is the case by walking locomotion.
Walking, running in the water and particularly swimming greatly enhances motor skill ability and motor skill diversity. Enhancing the ability and diversity of the motor skills has the consequence of enhancing the neuromuscular control centre. The state of the neuromuscular control centre (and the state of the central and periphery nervous system) to a great extent determines the state of the mental immune system.
When we are enhancing the neuromuscular control centre at the same time we are enhancing the mental immune system and enhancing the cognitive ability. (It appears that maintaining the neuromuscular control centre in the optimal state will ward against neuron-cognitive diseases, like Alzheimer etc).
On the other side, the sensory contact between the body surface and the water is providing stimulation for the central and periphery nervous system. Actually, the increased sensory contact caused by water has the consequence that the periphery and the central nervous system are more active
In every day life we are not aware that by taking shower and washing the face with water that has a temperature different from temperature of the body we unknowingly activate the nervous system. By doing this we are stimulating the periphery and central nervous system.
By stimulating the periphery nervous system, the central nervous system is more than usually active. (Providing optimal sensory stimulation to the periphery nervous system is what maintains the periphery and the central nervous system in the optimal condition).
Staying inside for prolonged period of time will negatively effect not only the neuromuscular control centre but will also negatively affect the central and the periphery nervous system, because the inside of the house the air temperature is constant for most of the time.
Apart from the benefits for musculoskeletal system and motor skills, regularly taking even short walk outside in the fresh air will positively affect the central and the periphery nervous system.
Walking with bare feet on the sandy beaches and in the water is an effective way for maintaining and improving the motor skill ability and diversity of motor skills, and has positive consequences for the neuromuscular control centre and the central and the periphery nervous system, and people living in the southern part of Florida, compared to the most part of the rest of USA, have more opportunities to do that.
Walking with bare feet demands an increased level of mental awareness about the surface and small objects that are on the ground like sharp stones etc and that is the factor that demands constant mental awareness for the time of doing this activity and is impossible to walk by maintaining habitual walking pattern. On the other side walking with bare feet obligates us to be more aware of the surrounding environment.
Walking while wearing footwear doesn’t obligate us to take care where we are stepping and how we are stepping and because of that fact we can do locomotion by using habitually walking pattern.
One more fact is that by walking with bare feet has the consequence of increased sensory stimulation to periphery nervous system because of the increased sensory contact between the bottom of the feet and the ground (increased sensory contact with environment).
According to epidemiological studies the northern part of Florida has higher incidences of stroke than the southern part of Florida.
The incidences of stroke in the northern part of Florida are similar in magnitude to the incidences of stroke in the Stroke Belt States
In the southern part of Florida, the great majority of people live in the coastal areas near the beaches, and a reason for this is that the inland of south Florida is mainly a swamp. In the northern part of Florida, much more people live in the inland area and because of that, people in the north part of Florida have fewer opportunities to walk with bare feet and less opportunity to be engaged in water sport than the people in south Florida.
The physical geography’s effect on the life style and on daily locomotion explains why people in the south part of Florida are less prone to the strokes than people living in the north part of Florida and the people living in the rest of the US, excluding the New York metropolitan area.
The New York metropolitan area has the lowest stroke rates in the USA. If we take a look in the map of this area, we can see that the entire New York metropolitan area is located on flat surfaces similar as the coastal plain sectors of Georgia, South Carolina and North Carolina where the incidence of strokes is the highest in the US.
The people living in the New York metropolitan area have much less opportunities to walk with bare feet compared to people living in the coastal plain sectors in Georgia, South Carolina and North Carolina, and far less than people living in the northern and southern part of Florida.
All physical geographical factors which contribute to lower incidence of the stroke states located on the hills and mountains like the States in the West and Northeast or the States in the Southeast like Florida (Southern part of Florida), in the New York metropolitan area are non existent.
This all tells us that in the New York metropolitan area, the incidences of stroke should be higher then in the coastal plain sectors of Georgia, South Carolina and North Carolina, but contrary, they are far lower then anywhere in the US.
One important factor which makes the New York metropolitan area different from any other part of the country is that people are using the public transport system like nowhere else in the US. Every weekday, four and half million people use the subway alone.
The people who use private cars are most of the time walking with the usual speed (habitually walk). For example; they do not need to hurry to catch their own car, the car always waits for them, it is always at home or in the parking place and they always can afford to walk with their usual speed. (The usual speed is the speed of habitual walk).
People, who use public transportation many times, come in a situation to increase their speed of the walk with the intention to catch the train or bus, and sometimes they decrease their walking speed below the habitual walking speed, with the intention to avoid waiting long on the station for the train or bus.
By changing the speed of the walk we are changing the way how neuromuscular control centre work. Each time when we change the speed of the walk from usual speed (habitual walking speed) to slow or to brisk walk, the activity of neuromuscular control centre is increasing.
The next important factor when travelling on the train is the effect of speeding train (effect of acceleration) and effect of slowing train (effect of deceleration) on the people inside the train.
For example, if we stand or walk on the floor of the train which moves at a constant speed, we need the same effort to maintain body in an upright position (upright posture) as we need when we are standing or walking on the not moving ground.
The ability to maintain upright body posture in still standing position is one o the motor skills ability.
Explained in simple terms; in still standing position on the non-moving ground, mainly the sense of balance coordinates work of the muscles in order to support body in an upright position. (The sense of balance is the vital component of the neuromuscular control centre.)
By still standing on solid ground and on the floor of the train that moving at constant speed the neuromuscular control centre is active to overcome the pull of gravity in order to maintain upright standing body posture.
But if we are standing or walking in the train at a time when the train increases speed, and at the time when the train decreasing the speed, the musculoskeletal system increases activity and at the same time the neuromuscular control centre increases activity in order to maintain upright standing posture (to avoid falling on the floor of the train).
When the body is affected by acceleration or deceleration the neuromuscular control centre has to work against the pull of gravity and at the same time it has to work against the effect of acceleration or the effect of deceleration in order to maintain an upright body posture.
Another fact is that the time between speeding and slowing of the train is only a few minutes long, because in the city area, the distance between the stations is short. For example, by travelling in the intercity train, we are spending much more time travelling with a constant speed. The time between speeding and slowing in an intercity train is much longer, because of the distance between stations is much bigger. In the case when we are travelling by subway (underground train – tube), we are affected every few minutes by the effects of speeding (effect of acceleration) and every few minutes we are affected by the effects of slowing (effect of deceleration).
Most of the time inside the train we spend sitting in the passenger seat, but we still are spending plenty of time standing and walking inside a slowing and speeding train, for example when we are entering a train and before we have the chance to reach the available seat, the train already starts to leave the station, and in this short time we are exposed to the effects of a speeding train, and at the time when the train is slowing down before it stops at the station, many times we have to leave the seat and walk towards the exit door because the time the train spends at the station is very short, just enough for some passengers to leave and for some passenger to enter in the train. In these situations, the neuromuscular control centre together with musculoskeletal system is forced to put more effort than usually to maintain upright body posture otherwise it will result in the fall on the floor of the train.
Another situation when we are unintentionally exercising our own motor skill is when we are walking in crowded areas, like; underground station or in the busy street, shopping centres etc. In this case we are frequently forced to change speed and direction to make the way trough the crowd.
From a mental point of view, the diversity of motion causes that we are more frequently mentally involved in locomotion. Mental involvement in physical activity is the factor that provides vital stimulations to the central nervous system. A diversity of motion (locomotion) is at the same time a diversity of physical activity. Diversity of physical activity is vital for the musculoskeletal system as well as being vital for the neuromuscular control centre.
Habitually physical activity doesn’t engage in a sufficient extent the neuromuscular control centre.
By prolonged time of doing habitually physical activities the neuromuscular control centre is underused.
For the time of performing habitual locomotion the musculoskeletal system is physically active but the neuromuscular control centre is under-active.
The next fact is that the use of public transport has the consequence of spending more time being on the feet compared to people that mainly use their own car for intercity travel.
One more important fact is that compared to people who are using their own car for everyday travel, the person who use mainly city public transport, (subway, public buses etc) are spending more time in outdoors temperature and that has the positive consequences for periphery and central nervous system.
This leads to the conclusion that in general, compared to the people who live in the rest of the USA, the people who live in the New York metropolitan area are more frequently forced to use a diversity of the motion (diverse motor skill) in order to perform every day locomotion and that has the consequence of lower incidents of strokes in the New York metropolitan area than anywhere else in the US.
The man made environment (city public transport) and man caused environment (crowded place) is responsible for lowest incidence of stroke in the New York Metropolitan area.
One thing that is left to explain is why in the United States, African Americans are more prone to stroke than White Americans. One fact is that a big percentage of African Americans live in an area known as the “Stroke Belt”. That alone is one factor that to some extent explains the higher incidence of stroke among the African American population. For example, African American men and women in the “Stroke Belt” area have a higher stroke death rate than their racial counterparts in other regions of the country. This means that African Americans living outside the “Stroke Belt” area have a lower stroke death rate than African Americans living inside the “Stroke Belt” area.
In this case, we can conclude that the differences in the physical geography of these regions and the differences in man made environments are responsible for the difference in the rates of stroke incidents among African Americans living in different parts of the country.
The next question is why African Americans proportionally have a higher rate of stroke incidence than White Americans who are living in the same geographical area.
In general, the affluent Americans have houses near the beach or have swimming pools at home, and in the towns and the city all over the country in flat areas or in areas with the hills and mountains, African American mostly have houses on the flat ground because the houses built on a flat ground are cheaper compared to the house build on hilly areas.
Proportionally, the more affluent population take regularly holydays (vacations) in different places and travel more compared to the less affluent population. In general, affluent populations travel outside their place of residency more than the less affluent population. The less affluent population tend to spend all or most of their time in their place of residency.
Those and similar other social inequality factors are the fact that African Americans are having in general less opportunity to exercises their own motor skill ability, and that negatively effects neuromuscular control centre and that has for the consequence of a higher susceptibility to strokes.
One more convincing fact is that after age of 55 the stroke mortality rate for White American increases and is equal to that of African Americans. Increased incidences of strokes after age of 55 by White Americans can be explained by decreased physical activities and decreased diversity of physical activity below the level necessary to maintain the neuromuscular control centre and central nervous system in an optimal condition.
In proportion, at a younger age, concerning a diversity of physical activity there is differences between White Americans and African Americans but after age of 55 proportionally there is little or no difference in diversity of physical activity between White Americans and African American.
The theories based on racial and/or genetics susceptibility to stroke are absolutely wrong.
In my strong opinion, all the theories about racial and/or genetic susceptibility to stroke are made by people who know little or nothing about genetics and heredity. Those theories are not the product of critical thinking and creative mind but they are born out of “IntelliGENE Design Theory” and shouldn’t be subject to any further discussion related to cause, treatment and prevention of stroke.
If for any reason a man believes that he is more prone to stroke he is already more prone not only to stroke but as well as prone to waste a number of negative health conditions because of such beliefs.
Believing to be more prone to certain negative health condition does not have any ground in science but is a product of negative thought or is induced by bad science.
Negative thought about our own susceptibility to stroke is weakening the mental immune system and the entire immune system in general. Positive mental attitude strengthens the mental immune system. The nonsense based on the grain of science doesn’t have any positive effect on stroke incidence and stroke mortality among African American but it is very likely that it contributes to raise a few percentages to an already high number of incidences of stroke among African Americans.
The fact that the incidence of stroke and mortality of stroke are higher among the African Americans compared to white Americans is not because of genetics but it is because till now no one really knows why that is happening.
Proportionally, White Americans are affected with stroke, not because of genetic, but because till now no one really knows why some people are affected with stroke and others not.
African Americans are proportionally more affected with stroke but not because of genetics but because in the first place till now no one really knows what makes some humans more than others vulnerable to stroke.
It is to concluded that African Americans and White Americans by doing the same physical activity in the same geographical and the same man made environment are equally prone or not prone to stroke.
The last puzle in stroke belt mystery is the fact that individuals who had resided in the Stroke Belt in childhood experienced heightened stroke risk at ages 50 and older, even if they had migrated out of the Stroke Belt
The recent study (Glymour et al. 2007)) reported that “adults who had resided in the stroke belt during childhood and had moved outside the region had higher stroke risk at ages 50 and older than adults who grew up in areas with lower stroke incidence.”
Most of the motor skills, like swimming and riding the bike, humans learn during the childhood. Acquiring motor skills in childhood and in adulthood has long lasting effect on the neuromuscular control centre.
Physical geography and man made environments in the “stroke belt area” to a lesser extent offer opportunity to learn and to master motor skills compared to physical geography and man made environments in the rest of the USA.
Compared to the children living outside the “stroke belt area”, the children living inside the stroke belt area proportionally has less opportunity to learn and master motor skills.
Once learned to ride a bike will stay with them for a long time even if a man does not ride a bike for many years, he is still able to ride a bike.
Learning to swim will stay for rest of the life even if a man does not swim for many years; the swimming skill is wired into the brain.
Learning and mastering the motor skills is what builds, maintains and enhances the neuromuscular control centre and mental immune system.
Being able to walk doesn’t make a man able to swim or to ride a bicycle. But being able to walk makes us able to walk in a different geographical environment. This means that some skills we have to learn like riding the bike and swimming and some skills we don’t need to learn but we can further master, like walking skills on the uneven ground, on the ground covered with pebbles, barefoot walking etc. (hilly and mountains region)
Certain environments enable us to walk without the necessity to further mastering our walking skill and some environment forces us to improve our existing walking skill.
Learning/acquiring motor skills like walking, swimming and riding bicycle has long lasting effect on neuromuscular control centre and in general on the entire neuromuscular control system as well as it has a long lasting positive consequences for mental immune system.
On one side, learning a new motor skill and on the other side. Mastering an already acquired motor skill has a lasting effect on neuromuscular control centre and mental immune system.
At any age human can learn new motor skill (like swimming, diving, riding the bike etc) and also he can master existing motor skill (walking skill, jumping and landing skill etc).
It appears that small things like taking a little care about neuromuscular control centre by learning new motor skill and by mastering already acquired motor skill or just by maintaining existing motor skill ability will make everyone, whether he grew up in the stroke belt area or anywhere in USA or in the world, stronger against stroke (less vulnerable to stroke).
It is obvious that living in an area where the incidence of strokes are lower than anywhere in the country will not make anyone less susceptible to stroke but the physical activity that causes optimal neuromuscular control centre activity is a factor that makes human less prone to stroke.
On the other side, it is obvious that living in an area where the incidences of stroke are highest in the country does not make anyone more prone to stroke but daily physical activity that does not involve to a sufficient extent the neuromuscular control centre is factor that makes anyone, whether is White American or African American, more prone to stroke.
Living in any particular geographical area has advantages and disadvantages. For example in the south east of USA there is higher incidence of stroke compared to rest of the USA. On the other side in the South East of USA there is lower incidence of autism compared to the North east and the North West of the USA.
It is well known that by a prolonged time of physical inactivity the muscles and bones lose strength and mobility. This is to conclude that by prolonged time of under-activity of central and periphery nervous systems and by prolong time of under-activity of the neuromuscular control centre the mental immune system loses strength.
Even occasionally walking barefoot on the grass or sandy beaches will positively affect everyday walking pattern. This means that by improving in our barefoot walking skill will have positive consequences for our everyday walking patterns. (It will positively effect habitually walking pattern) and will have lasting positive consequences for neuromuscular control centre.
By everyday walking, even, occasionally, for a few minutes, using consciously effort for a few minutes to maintain optimal body posture and balanced gait will reduce the risk of stroke and it is because by using consciously effort the neuromuscular control centre is far more active than what is the case with habitual locomotion and habitual body posture.
By everyday sitting or standing, occasionally, for a few minutes or less, using conscious effort to maintain body posture in still standing position or for the time of sitting the neuromuscular control centre is far more active than what is case by habitually maintaining sitting or standing body posture.
Incorporating diverse and simply, non-strenuous and at the same time enjoyable physical activity and/or postural and motor skill exercise in every day life will be the most effective measure towards stroke and many common diseases and health conditions.
It needs to take in consideration that slow walking or brisk walking for prolonged period of time is not fully beneficial for neuromuscular control centre because after some period of walking at the same speed this type of walk will start to be habitual. The best way to exercise the neuromuscular control centre is from time to time to change the speed of the walk.
A few minutes a day of physical activity that causes increased activity of neuromuscular control centre will greatly reduce the possibility of stroke for everyone independent of the physical geography and independent of the man made environment.
Physical activities that have a protective role against strokes are at the same time are highly effective as a means to achieve effective recovery after stroke and as well as have the protective role against reoccurrence of stroke.
Please note: Not every physical activity is beneficial for neuromuscular control centre.
For example doing exercises on stationary bike (moving the pedals without moving from one place to another).
Another example of not helpful physical activities is exercises on a treadmill.
Inflatable bouncy house-castle, inflatable obstacle courses and trampoline are nowadays popular exercising devices that need to be avoided.
The article contains more explanation about how certain man made environment promotes harmful physical activities.
Also, there is more explanation of how certain physical activity negatively effects; the neuromuscular control system, the central and peripheral nervous system and the mental immune system.