Early mobilization of acute stroke patients.

OBJECTIVE

To examine the early mobilization of acute stroke patients.

DESIGN

Postal survey.

SETTING

Thirteen health boards in Scotland.

PARTICIPANTS

Ninety-nine health professionals of whom 39 were doctors, 39 nurses and 21 physiotherapists.

RESULTS

There was a lack of understanding and agreement across the three professions in terms of what was meant by 'early mobilization'. Further, the duration, frequency, intensity, risk/benefits and activities associated with early mobilization are undescribed despite clinical guidelines urging its use. Multi-disciplinary decision making regarding early mobilization was not self-evident.

CONCLUSIONS

(i) An evidence-base for early mobilization is required along with agreement on what physiological monitoring should be undertaken while early mobilization is on going; (ii) Health professionals need a greater awareness of the evidence linking stroke complications with patient immobilization and in particular in relation to pressure sores, painful shoulder and falls; (iii) The clinical decision to mobilize an acute stroke patient early should be made explicitly within a multi-disciplinary acute stroke team; (iv) There is an absolute need for further research into early mobilization in terms of intensity, duration, frequency, risks and benefits in relations to types of stroke of early mobilization.

RELEVANCE TO CLINICAL PRACTICE

Early mobilization in acute stroke care is recommended in a range of European, American and UK policy guidelines as a strategy to minimize or prevent complications. However the evidence-base to support early mobilization in acute stroke is missing. Health professionals require a research-based approach in order to deliver safe and effective early mobilization to acute stroke patients.