EARLY mobility within the first 24 hours of hospital admission can significantly improve functional outcomes for patients with acute ischaemic stroke (AIS) who receive intravenous thrombolysis, according to recent findings. This research highlights the potential benefits of early physical and occupational therapy in enhancing recovery.
Gunjanpreet Kaur, Saint Louis University School of Medicine, Missouri, USA, and colleagues, reviewed a total of 168 patients with AIS who received intravenous thrombolysis between January 2020–April 2023. The authors categorised early mobility as any evaluation by physical and occupational therapists within the first 24 hours of stroke symptoms. Functional outcomes were measured using the modified Rankin Scale at 90 days, with a score <2 indicating good functional recovery. Secondary outcomes included the National Institutes of Health Stroke Scale (NIHSS) scores at discharge, and the duration of hospitalisation.
Of the 168 patients reviewed, 55 (32%) received early mobility interventions (54.5% male). This group tended to be slightly younger, with a median age of 65 years, compared to 67.5 years in the non-mobility group.
Findings revealed that patients who underwent early mobility had significantly higher odds of achieving an excellent modified Rankin Scale score of 0–1 at 90 days (odds ratio: 2.96; 95% confidence interval: 1.38–6.37; P=0.005) and at discharge (odds ratio: 5.47; 95% confidence interval: 2.49–12.04). Additionally, these patients experienced shorter hospital stays, with a median duration of 4 days, compared to 6 days for those who did not receive early mobility interventions (P<0.001). However, no significant differences were observed in the NIHSS score changes from baseline to discharge between early mobility group and the control group.
In conclusion, this study supports the integration of early mobility protocols in the management of patients with AIS post-thrombolysis, emphasising its role in improving long-term functional outcomes and reducing hospital stay duration. Further research is warranted to explore the mechanisms behind these benefits, and to refine early mobility strategies for broader clinical application.
Reference:
Kaur G et al. Effects of early mobilization on functional outcomes in patients with acute ischemic stroke who received intravenous thrombolysis. Neurol. 2024;102(1):17.
