Very early mobilization after stroke fast tracks return to walking

This trial examined whether earlier and more intensive physical activity after a stroke could reduce the recovery time necessary to achieve walking independence.

Approximately two thirds of patients are unable to walk without assistance in the initial weeks following a stroke. Physical therapy and activity are an important part of rehabilitation, and most patients show progressive walking improvement with training. However, the exact nature of walking rehabilitation and specifically the optimal time to begin training is of some debate. 

71 patients admitted into 2 stroke units were randomized to receive either very early and intensive care (early mobilization group), or standard of care physical therapy. In the very early and intensive care group patients began physical therapy within 24 hours of admission, and received extra assistance to encourage sitting up and moving around as frequently as possible. The number of days required for a patient to return to walking 50 meters without assistance was compared between the two groups.

Results showed that patients receiving very early and intensive mobilization care returned to walking independently significantly faster than patients receiving standard stroke unit care. On average, patients mobilized earlier met the goal after only 3.5 days, compared to 7 days for patients receiving standard care. After 2 weeks of physical therapy 67% of patients in the early mobilization group achieved unassisted walking, compared to only 50% of patients receiving standard care.

This study concluded that early mobilization and physical therapy may benefit walking recovery in patients after a stroke.

This phase II study involved only a small number of patients. In addition, factors such as the severity of the stroke, the age of the patient, and concurrent conditions such as diabetes significantly influenced results.