The Typical Ward of TCM, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ann Palliat Med. 2021 Nov;10(11):11776-11784. doi: 10.21037/apm-21-2997.
The incidence of stroke is increasing year by year, which seriously affects the quality of life of patients in the later period. At present, there is no clear evidence-based medical support for very early mobilization (VEM). Therefore, this study aims to systematically evaluate the effect of VEM intervention on patients with acute stroke in order to further understand the application value of VEM.
The Cochrane Library, PubMed, Embase, Web of Science, CNKI, and other databases were searched for randomized controlled trials (RCTs) on the VEM of patients with acute stroke. The articles were screened according to the inclusion and exclusion criteria. Data was extracted and the quality of the studies was evaluated. Revman 5.3 software was used to analyze the impact of VEM on adverse events after stroke, the disability rate, bed-related complications, length of hospital stay, and ability of daily living.
After screening, 8 studies reported on the efficacy of VEM intervention for stroke patients. After analysis, VEM had no significant relationship with adverse events [relative risk (RR): 1.18; 95% confidence interval (95% CI): 0.94-1.47], disability rates (RR: 1.05; 95% CI: 0.95-1.15), and bed-related complications (RR: 0.84; 95% CI: 0.66-1.06). VEM was related to length of hospital stay [mean difference (MD): -1.72; 95% CI: -2.63 to -0.81] and ability of daily living (MD: 4.97; 95% CI: 0.15-9.79).
VEM can shorten the hospital stay and improve the activities of daily living of patients. Additionally, it will not increase the adverse events, bed-related complications, and disability rates of acute stroke patients, suggesting that VEM is safe and effective.
中风的发病率逐年上升，严重影响了患者后期的生活质量。目前，对于极早期运动（VEM）还没有明确的循证医学支持。因此，本研究旨在系统评价 VEM 干预对急性中风患者的效果，进一步了解 VEM 的应用价值。
检索 Cochrane 图书馆、PubMed、Embase、Web of Science、CNKI 等数据库中关于急性中风患者 VEM 的随机对照试验（RCT）。根据纳入和排除标准筛选文章，提取数据并评价研究质量。使用 Revman 5.3 软件分析 VEM 对中风后不良事件、残疾率、卧床相关并发症、住院时间和日常生活能力的影响。
筛选后，有 8 项研究报道了 VEM 干预对中风患者的疗效。分析结果显示，VEM 与不良事件无显著相关性[相对危险度（RR）：1.18；95%置信区间（95%CI）：0.94-1.47]、残疾率（RR：1.05；95%CI：0.95-1.15）和卧床相关并发症（RR：0.84；95%CI：0.66-1.06）。VEM 与住院时间[均数差（MD）：-1.72；95%CI：-2.63 至-0.81]和日常生活能力（MD：4.97；95%CI：0.15-9.79）相关。
VEM 可以缩短住院时间，提高患者的日常生活能力。此外，它不会增加急性中风患者的不良事件、卧床相关并发症和残疾率，表明 VEM 是安全有效的。
