Early rehab good for stroke patients

Starting rehabilitation within 24 hours after a person has a stroke appears to be safe and beneficial. This type of intervention has not been tested before in high-quality trials, most likely due to the fact that people have believed that early after a stroke, patients could not participate in early intensive exercise therapy or that it might not be safe. Australian researchers conducted a study of 71 stroke patients who were randomly assigned to very early rehabilitation plus standard care or to standard care alone. At three months after the stroke, 8 of the 38 patients in the very early group and 3 of the 33 in the standard care group had died. This difference was not significant from a statistical standpoint, and almost all deaths were in patients with severe stroke. The number of serious adverse events, including stroke progression and pneumonia, were similar in both groups, as was the rate of falls. After adjustment for factors such as age, patients in the early rehab group were more likely to have a good outcome at the one-year mark - 39 percent versus 24 percent. Having shown the safety and feasibility of the approach, the researchers have now started a larger trail that will include over 2000 patients. They prove that early intensive exercise therapy, with a focus on mobility training (a simple, practical intervention) is an invaluable and cost effective treatment for the 80 percent of people who are not suitable or unable to access clot-busting drugs.