Very early versus delayed mobilisation after stroke.

Bernhardt J, Thuy MN, Collier JM, Legg LA.

The objectives of this review were to determine the benefits and harms of very early mobilisation (commenced within 48 hours of stroke) compared with conventional care.  Selection criteria included unconfounded RCTs of acute stroke patients, comparing an intervention group that started out of bed mobilisation within 48 hours of stroke and aimed to reduce time to first mobilisation and/or increase the amount or frequency (or both) of mobilisation, with conventional care. Following the literature search and analysis one study, involving 71 participants, was included. In this study the experimental group had earlier and more frequent mobilisation than the control group during admission. Fewer patients who received early and frequent mobilisation were dead or disabled at three months, but this was not statistically significant and the confidence intervals were wide. No significant difference on any secondary outcomes of interest were found.

Insufficient evidence was found to support or refute the efficacy of routine very early mobilisation after stroke, compared with conventional care. More research is required to determine the benefits and harms of very early mobilisation after stroke.

Cochrane Database, 2009, (1), CD006187.

Link to Abstract  (full text available)