Effect of very early mobilisation on functional status in patients with acute stroke: a single-blind, randomized controlled trail

Abstract

Objective: To evaluate the effect of very early mobilisation on functional status following acute stroke.

Design: Single blind, randomized controlled trial.

Setting: University hospital.

Subjects: Eighty-six patients with acute stroke (42 men and 38 women) aged 30-80 years were randomized to an Intervention group and a Standard care group.

Interventions: All participants received 45 minutes standard care once a day for seven days. In addition, the intervention group (n=43) performed very early mobilisation consisting of early and frequent out of bed activities which started within 24 hours of stroke onset for 5 to 30 minutes at least twice a day, for seven days.

Outcome measures: Functional status was measured with Barthel ADL Index on admission, discharge and three months follow up.

Results: Intervention group showed a significant improvement in Barthel Index change scores (discharge - admission) (median=35, IQR=30-38.75 versus median=17.50, IQR=10-30) than the standard care group. Intervention group showed a significant improvement in Barthel Index change scores (three month follow up - admission) (median=42.50, IQR=35-55) versus (median=30, IQR=20-35) than the standard care group. The Intervention group reported statistically significant improvement in functional status at discharge (P<0.001) and at three months follow up (P<0.001) compared with the Standard care group.

Conclusions: The results indicate that very early mobilisation in addition to the standard care may be effective in improving the functional status following acute stroke.

Keywords: Acute stroke; Barthel ADL Index; functional status; standard care (SC); very early mobilisation (VEM).