Featured Review: Very early versus delayed mobilisation after stroke

Does very early and active mobilisation improve recovery after stroke?

Care in a stroke unit is recommended for people soon after a stroke, and results in an improved chance of surviving, returning home, and regaining independence. Very early mobilisation (helping people to get up out of bed very early, and more often after the onset of stroke symptoms) is performed in some stroke units, and is recommended in many acute stroke clinical guidelines. However, the impact of very early mobilisation on recovery after stroke is not clear.

This review identified nine trials (2958 participants), although one trial (2104 participants) provided most of the information. On average, very early mobilisation participants started mobilisation 18.5 hours after their stroke, compared with 33.3 hours in the usual care group.

Review author Prof. Julie Bernhardt said: 

“Very early mobilisation did not increase the number of people who survived or made a good recovery after their stroke but there was a suggestion that very early mobilisation may reduce the length of stay in hospital by about one day. 

“However the results raised the concern that starting intensive mobilisation within 24 hours of stroke may carry some increased risk, at least for some people with stroke and this potential risk needs to be clarified.”