Early physical rehabilitation therapy between 24 and 48 h following acute ischemic stroke onset: a randomized controlled trial

Abstract

Purpose

Early mobilization is believed to be helpful for patients with acute ischemic stroke. This study aimed to compare the difference between starting rehabilitation between 24 and 48 h and 72 and 96 h following the onset of ischemic stroke.

Materials and methods

This was a single-center, single-blind, randomized controlled trial. The early rehabilitation (ER) group started exercising between 24 and 48 h after stroke onset, which the standard rehabilitation (SR) group started exercising between 72 and 96 h. The two groups received sitting, standing, and repetitive body strength training respectively.

Results

In this study, 110 patients were analyzed. Patients in the early rehabilitation group had more favorable outcomes (The modified Rankin scale score 0-2, ER group = 32 versus SR group = 20, adjusted odds ratio 2.27, 95% CI 1.05-4.87; p = 0.036) at 3-month follow-up. The simplified Fugl–Meyer assessment (FMA) scores for the lower extremity were influenced by the interaction effect (F = 7.24, p = 0.01). The post-hoc analysis revealed a difference in the lower extremity FMA score at one week after stroke (difference 2.30 (95% CI 0.65–3.96); p = 0.007).

Conclusions

Early physical rehabilitation training between 24 and 48 h may be beneficial and improve patients’ lower extremity function within the first week.

Clinical Trial Registration Unique identifier

NCT02718534

Implications for rehabilitation

• Acute ischemic stroke has a variety of symptoms, and acroparalysis is a major concern.

• Starting physical rehabilitation early can improve the prognosis of patients with ischemic stroke.

• Early rehabilitation is more conducive to the recovery of lower extremity motor function, but in the subsequent rehabilitation process, the upper extremity function should be paid more attention.

Keywords:

• Ischemic stroke
• early mobilization
• rehabilitation
• extremity function
• randomized controlled trial

Disclosure statement

The authors have no commercial associations or sources of support that might pose a conflict of interest. The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article. This study was supported by a grant from the Health and Family Planning Commission of Liaoning Province (LNCCC-D12-2015).