In their aim to provide a guideline for healthcare providers about the timing, frequency and amount of in-hospital mobilization of stroke patients, researchers studied the care and recovery of more than 2,100 patients admitted to a hospital stroke unit, according to research presented at the American Stroke Association's International Stroke Conference 2016.
About half of those patients received frequent, early and higher amounts of mobilization, starting within 24 hours of their stroke. The other half received usual care, which involved lower-dose, and early mobilization. The researchers followed up with those patients three months later.
In the first study (abstract 76), researchers found that 46 percent of the early, higher dose-mobilizers experienced a good outcome compared with just over half of those receiving usual care, so higher dose mobilizing didn't improve outcome. Usual care shifted 28 minutes earlier each year with patients being encouraged to move out of bed sooner. The question of moving stroke patients out of bed earlier has been met with hesitation due to concern of harming the patient, but researchers found no overall differences in serious adverse effects. They also found that early, frequent out of bed activity helped prevent serious complications in those aged 65-80 years.
In another analysis (abstract 153), the researchers found that getting hospitalized stroke patients out of bed for frequent, but short bouts of movement helped increase the odds that they'll regain independence three months after their stroke. In this analysis they found:
- A consistent pattern of improved odds of favorable short-term stroke recovery with the use of more frequent out-of-bed sessions.
- Increasing the amount of time spent mobilizing in each session didn't work in the patients' favor, with higher amounts of time actually reducing the odds of patients' being independent at three months.
Session frequency appears to be important, but too much too soon may interfere with recovery.