Early mobilization in acute stroke phase: a systematic review

Miranda, Jéssica Mariana de Aquino; Borges, Viviany Mendes; Bazan, Rodrigo; Luvizutto, Gustavo José; Shinosaki, Jullyanna Sabrysna Morais

doi:10.1080/10749357.2021.2008595

Cited by 6 publications

(3 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another systematic review concluded that early mobilization improves outcome after stroke and the optimal time to start early mobilization is 24 hours after stroke according to hemodynamic stability and safety criteria. 3 The duration of mobilization recommended was between 15 and 45 minutes, divided into one, two, or three times a day and focused on sitting, standing, and walking. The AVERT study found that intensive early mobilization of stroke patients in general had adverse effects on outcome but that lesser doses of mobility had an uncertain risk/benefit profile and that further studies of a dose-response analysis are warranted.…”

Section: Discussionmentioning

confidence: 99%

Early Mobilization Post Acute Stroke Thrombolysis and/or Thrombectomy Survey

Silver

Demers-Peel

Alexandrov

et al. 2022

The Neurohospitalist

View full text Add to dashboard Cite

Background We sought to determine mobilization practices following emergency stroke therapy in centers across the United States. Methods We surveyed hospitals in the NIH StrokeNet regarding mobilization practices following acute stroke thrombolysis and/or thrombectomy. An anonymous survey was sent out to all StrokeNet sites Survey questions included stroke center designation, location of admission, whether a formal bed rest protocol was in place, minimum bed rest period required, which person first mobilized the patient. Results 48 centers responded to the survey including 45 Comprehensive Stroke Centers and 3 Primary Stroke Centers. Most patients were admitted to a neuro-intensive care unit (54%), others to a general medical/surgical ICU, stroke ward, or combination. 60% of respondents indicated that a formal bed rest policy was in place. Minimum bed rest requirements after thrombolysis alone ranged from 0 to 24 hours (35% with a 24-hour bed rest protocol, 19% with no minimum, 13% with a 12-hour minimum, 4% with an 8-hour minimum, 4% with a 6-hour minimum, and 6% with a variable rest period). Similar variations were reported in patients undergoing thrombectomy with ranges from 0 to 24 hours bed rest. First mobilization was by a nurse 52% of the time and by a physical therapist 48% of the time. Conclusions Mobilization practices following emergency ischemic stroke reperfusion treatments vary significantly across stroke centers. Mobilization of patients is performed primarily by nurses and therapists. Further study regarding an optimal approach for mobilization following acute ischemic stroke thrombolysis and/or thrombectomy is warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Early Mobilization Post Acute Stroke Thrombolysis and/or Thrombectomy Survey

Silver

Demers-Peel

Alexandrov

et al. 2022

The Neurohospitalist

View full text Add to dashboard Cite

show abstract

“…Participants were recruited from stroke patients within 3 days of stroke onset who were admitted to Juntendo University Urayasu Hospital in Japan from March 2018 to March 2023. The definition of acute rehabilitation initiation is often adopted within 3 days after stroke onset ( 21 ). Therefore, the participants in this study were patients who received acute rehabilitation.…”

Section: Methodsmentioning

confidence: 99%

Quadriceps muscle activity during walking with a knee ankle foot orthosis is associated with improved gait ability in acute hemiplegic stroke patients with severe gait disturbance

Hayashi,

Yamazaki,

Komatsu

et al. 2024

Front. Neurol.

View full text Add to dashboard Cite

IntroductionA knee-ankle-foot orthosis (KAFO) prevents knee buckling during walking and enables gait training for acute hemiplegic stroke patients with severe gait disturbances. Although the goal of gait training with a KAFO is to improve gait ability, that is, to acquire walking with an ankle-foot orthosis (AFO), it is not clear how gait training with a KAFO contributes to improving gait ability. Therefore, this study aimed to investigate the relationship between muscle activities during walking with a KAFO and the improvement of gait ability in hemiplegic stroke patients with severe gait disturbance.MethodsA prospective cohort study was conducted. Fifty acute hemiplegic stroke patients who could not walk with an AFO participated. Muscle activities of the paretic rectus femoris, biceps femoris, tibialis anterior, and soleus were assessed with surface electromyogram during walking with a KAFO. Electromyograms were assessed at the beginning of gait training and at the time the Ambulation Independence Measure score improved by 3 or higher, or discharge.ResultsEven in patients with complete hemiplegia, paretic rectus femoris, biceps femoris, and soleus showed periodic muscle activity during walking with a KAFO. Twenty-three patients improved to an Ambulation Independence Measure score of 3 or higher and were able to walk with an AFO (good recovery group). At the beginning of gait training, paretic rectus femoris muscle activity during the first double-limb support phase was significantly higher in the good recovery group than in the poor recovery group. The rectus femoris muscle activity significantly increased from before to after acute rehabilitation, which consisted mainly of gait training with a KAFO.DiscussionFor acute hemiplegic stroke patients with severe disturbance, the induction and enhancement of paretic quadriceps muscle activity during walking with a KAFO play an important role in acquiring walking with an AFO.

show abstract

“…Numerous factors have been identified that play a role in the development of disability in patients with stroke, such as age [ 3 ], stroke severity [ 4 ], comorbidities [ 5 ], premorbid functional status [ 6 ], or stroke type [ 7 ] and location [ 8 ]. In addition to these potential factors, the effects of interventions such as recanalization [ 9 ], early mobilisation [ 10 ], and post-stroke conditions, such as the incidence of stroke-related complications [ 11 ], also affect the functional outcomes in these patients.…”

Section: Introductionmentioning

confidence: 99%

Muscle weakness is more strongly associated with functional outcomes in patients with stroke than sarcopenia or muscle wasting: an observational study

Nozoe,

Kubo,

Yamamoto

et al. 2024

Aging Clin Exp Res

View full text Add to dashboard Cite

Background Stroke-related sarcopenia is an important prognosis factor and an intervention target for improving outcomes in patients with stroke. Aim This study aimed to identify the association between sarcopenia, possible sarcopenia, muscle weakness, muscle mass and calf circumference, and the functional outcomes 3 months after stroke. Methods In this single-centre prospective observational study, muscle strength, muscle mass, and calf circumference were measured in patients with acute stroke at hospital discharge. Diagnosis of sarcopenia, possible sarcopenia, muscle weakness, low muscle mass, and low calf circumference were defined according to the 2019 Asian Working Group for Sarcopenia criteria. The primary outcome measure was the modified Rankin Scale (mRS) score at 3 months, with an mRS score of 3 or higher indicating a poor outcome. Logistic regression analysis was conducted to examine independent associations between each assessment and functional outcomes. Results A total of 247 patients (median age: 73 years) were included in this study. The prevalence of sarcopenia was 28% (n = 70), and in the adjusted model, sarcopenia (aOR = 2.60, 95% CI 1.07–6.31, p = 0.034), muscle weakness (aOR = 3.40, 95% CI 1.36–8.52, p = 0.009), and low muscle mass (aOR = 2.61, 95% CI 1.04–6.52) were significantly associated with poor functional outcome. Nevertheless, other evaluations did not demonstrate an independent association with the outcome. Conclusion Sarcopenia, muscle weakness, and low muscle mass were found to be independently associated with functional outcomes 3 months after stroke, and muscle weakness exhibited the strongest association with outcomes among them.

show abstract

Early mobilization in acute stroke phase: a systematic review

Cited by 6 publications

References 44 publications

Early Mobilization Post Acute Stroke Thrombolysis and/or Thrombectomy Survey

Early Mobilization Post Acute Stroke Thrombolysis and/or Thrombectomy Survey

Quadriceps muscle activity during walking with a knee ankle foot orthosis is associated with improved gait ability in acute hemiplegic stroke patients with severe gait disturbance

Muscle weakness is more strongly associated with functional outcomes in patients with stroke than sarcopenia or muscle wasting: an observational study

Contact Info

Product

Resources

About