Early mobility in acute ischemic stroke linked to better outcomes at 90 days

Key takeaways:

•     Early mobility was considered as an evaluation from physical and occupational therapy during the first 24 hours of stroke symptoms.

•     Patients with stroke given early mobility had fewer days hospitalized compared with those not given the intervention.

DENVER — Patients with acute ischemic stroke who received IV thrombolysis and were allowed mobility within the first 24 hours of onset saw better functional outcomes in 90 days, according to a poster presentation.

“The early mobility time period is anywhere from 24 hours to 72 hours,” Gunjanpreet Kaur, MD, a neurology resident at Saint Louis University School of Medicine, told Healio at the American Academy of Neurology annual meeting. “What we did with our retrospective study is we started ordering early mobility, it’s a specific order set at our institute where we see patients within their 24-hour window.”

Early mobilization for individuals with acute ischemic stroke (AIS) after receiving IV thrombolysis may benefit the patient; however, the body of knowledge is limited, Kaur and colleagues wrote.

Kaur and colleagues aimed to assess whether mobility within 24 hours of hospital admission for those with AIS is associated with better functional outcomes defined as a modified Rankin Scale (mRS) score of less than 2.

Their retrospective chart review yielded 168 persons with AIS given IV thrombolysis (median age 67.5 years) between January 2020 and April 2023. Early mobility was considered as an evaluation from physical and occupational therapy during the first 24 hours of stroke symptoms.

The primary outcome was mRS score at 90 days and the secondary endpoint was National Institutes of Health Stroke Scale (NIHSS) score at discharge and total days of hospitalization. A total of 55 individuals (median age 65 years; 54.5% male) were subject to early mobility protocol.

Results showed that individuals with early mobility orders recorded higher odds of having an excellent mRS (0 to 1) at 90 days (OR = 2.96; 95% CI: 1.38-6.37) and at discharge (OR = 5.47; 95% CI: 2.49-12.04).

Data further showed the number of hospitalized days were fewer for those in the early mobility group (median days 4 vs. 6); however, no significant difference was found in NIHSS change between baseline and discharge among early mobility and non-protocol individuals.

“The earlier we get (patients) moving, the better they do at discharge and at 90 days,” Kaur said. “I think it’s time we should standardize (IV thrombolysis to within 24 hours).”