Effects of Early Mobilization after Acute Stroke: A Meta-Analysis of Randomized Control Trials.

Abstract

BACKGROUND:

Early mobilization is inconsistently associated with the recovery of stroke. We aim to examine the effect of early mobilization on patients with acute stroke.

METHODS:

PubMed, EMBASE, and the Cochrane library were searched up to April 2017. Randomized controlled trials that reported risk estimates or mean with standard deviation were included. Primary outcomes were defined as modified Rankin scale score 0-2 and mortality, and secondary outcomes were Barthel Index, length of stay, and incidence of complications. Summary relative risk, standardized mean difference (SMD), and weighted mean difference (WMD) were calculated as needed. Sensitivity analyses were also conducted to test stability of results.

RESULTS:

Six studies (8 publications) were included to analyze the effects of early mobilization after stroke. No differences between groups were observed for modified Rankin scale 0-2 (relative risk [RR]: .80; 95% confidence interval [CI]: .58-1.02; I2=45%) and the risk of death (RR: 1.21, 95% CI: .76-1.65; I2=0%). Compared with conventional practice, early mobilization was superior in Barthel Index (SMD: .66; 95% CI: .00-1.31; I2=85.9%), and shorter hospital stay for stroke patients (WMD: -1.97; 95% CI: -2.63 to -1.32; I2=15.3%). We found no significant difference between groups on the incidence of complications.

CONCLUSIONS:

Current evidence revealed that no statistical significant difference between early mobilization and non-early mobilization was observed on modified Rankin scale score 0-2 and mortality. Interestingly, early mobilization is associated with an increased Barthel Index and shorter hospital stay for patients. Further research is necessary to verify the effect of early mobilization on patients with acute stroke.

• Authors: Zhuyue Li, Xuemei Zhang, Kang Wang, Jin Wen
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) Vol. 27 Issue 5 Pg. 1326-1337 (May 2018) ISSN: 1532-8511 [Electronic] United States
• PMID: 29373228 (Publication Type: Journal Article, Meta-Analysis, Review)
• Copyright: Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Disability Evaluation
• Early Ambulation (adverse effects, mortality)
• Female
• Health Status
• Humans
• Length of Stay
• Male
• Middle Aged
• Randomized Controlled Trials as Topic
• Recovery of Function
• Risk Factors
• Stroke (diagnosis, mortality, physiopathology, therapy)
• Stroke Rehabilitation (adverse effects, methods, mortality)
• Time Factors
• Treatment Outcome