Very early mobilization in the stroke unit: Functionality, quality of life and disability at 90 days and 1 year post-stroke

Article type: Research Article

Authors: Hernández-Méndez, Beatriz^{a; c; *} | Martín-Silva, Isabel^a | Tapias-Vilanova, Martí^a | Moreno-Gallo, Yolanda^a | Sanjuan-Menendez, Estela^{b; d} | Lorenzo-Tamayo, Eva^b | Ramos-González, Montserrat^b | Montufo-Rosal, Marina^b | Zuriguel-Pérez, Esperanza^c

Affiliations: [a] Physical Medicine and Rehabilitation Service/Physiotherapy and Occupational Therapy Unit, Vall d’Hebron Hospital Universitari, Barcelona, Spain | [b] Neurology Service/Stroke Unit, Vall d’Hebron Hospital Universitari, Barcelona, Spain | [c] Multidisciplinary Nursing Research Group, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain | [d] Stroke Research, Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Hospital Universitari, Barcelona, Spain

Correspondence: [*] Address for correspondence: Beatriz Hernández-Méndez, RPT, MSc, Physical Medicine and Rehabilitation Service/Physiotherapy and Occupational Therapy Unit, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain. Tel.: +34 934893447; E-mail: [email protected].

Abstract: BACKGROUND:The evidence of early mobilization after stroke is conflicting, and the recovery period is an important concern. OBJECTIVE:To analyse the functionality, quality of life and disability at 90 days and 1 year post-stroke of patients who received a Very Early Mobilization Protocol. METHODS:Prospective cohort study in a tertiary stroke unit. Consecutive patients aged≥18 years and without prior significant disability, who presented motor deficit after acute stroke, were included. A symmetry test was performed to compare the changes in the main variables: Barthel Index (BI), Functional Ambulation Category (FAC), modified Rankin Scale (mRS) and EuroQol five-dimensions three-level (EQ-5D-3L) between 90 days and 1 year post-stroke. RESULTS:A total of 123 patients were recruited. The BI reflected an improvement at 1 year in transfer to chair/bed in 25.8%(p < 0.01) of patients and in toilet use in 25.8%(p = 0.02). The FAC showed an improvement at 1 year in 44.4%(p < 0.01) of patients and the mRS in 19.1%(p = 0.01). The usual activities dimension of the EQ-5D-3L showed a clinically relevant improvement after 1 year in 15.9%(p = 0.23) of patients. CONCLUSIONS:A significant percentage of patients show improvements in some functional areas and in disability between 90 days and 1 year post-stroke.

Keywords: Activities of daily living, disability evaluation, early mobilization, quality of life, stroke

DOI: 10.3233/NRE-210118

Journal: NeuroRehabilitation, vol. 49, no. 3, pp. 403-414, 2021