Early mobilization after acute stroke.

BACKGROUND

Treatment in stroke units reduces mortality and disability compared with treatment in general medical wards. Early mobilization is considered one element of stroke unit care contributing to this benefit. There are uncertainties regarding the effect of this approach on different groups of acute stroke patients. In this study, we compared the proportions of patients having a modified Rankin Scale score ≤2 assessed 3 months poststroke in patients mobilized within 24 hours versus between 24 to 48 hours of hospitalization, and explored whether other factors were associated with good outcome.

METHODS

Patients hospitalized within 24 hours of stroke onset were enrolled in this prospective, randomized, controlled trial with blinded outcome assessment. They were assigned to 2 groups; 1 that was mobilized within 24 hours of admittance and 1 that was mobilized 24 to 48 hours after admittance. Binary logistic regression was performed to analyze predictors of good outcome, with stepwise elimination of nonsignificant variables in the multivariate model. Candidate variables were mobilization within 24 hours of admittance, age, sex, stroke risk factors, and National Institutes of Health Stroke Scale score on admittance.

RESULTS

Twenty-seven patients were mobilized within 24 hours of hospitalization and 25 between 24 and 48 hours. The median times to first mobilization were 7.5 hours (interquartile range 2.5-16.3) and 30.0 hours (interquartile range 25.5-38.0), respectively. Fifty-five percent of patients had a good outcome. None of the candidate variables had a significant association with good outcome.

CONCLUSIONS

Neither time to mobilization nor any other candidate variable was associated with good outcome 3 months poststroke.