Document Detail

Very early mobilization after stroke fast-tracks return to walking: further results from the phase II AVERT randomized controlled trial.
MedLine Citation:
PMID:  21148439     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: regaining functional independence is an important goal for people who have experienced stroke. We hypothesized that introducing earlier and more intensive out-of-bed activity after stroke would reduce time to unassisted walking and improve independence in activities of daily living.
METHODS: a Very Early Rehabilitation Trial (AVERT) was a phase II randomized controlled trial. Patients with confirmed stroke (infarct or hemorrhage) admitted <24 hours after stroke and who met physiological safety criteria were eligible. Patients randomized to the very early and intensive mobilization group were mobilized within 24 hours of stroke and at regular intervals thereafter. Control patients received standard stroke unit care. The primary outcome for this analysis was the number of days required to return to walking 50 m unassisted. Secondary outcomes were the Barthel Index and Rivermead Motor Assessment at 3 and 12 months after stroke.
RESULTS: seventy-one stroke patients with a mean age of 74.7 years were recruited from 2 hospitals. Adjusted Cox regression indicated that very early and intensive mobilization group patients returned to walking significantly faster than did standard stroke unit care controls (P=0.032; median 3.5 vs 7.0 days). Multivariable regression revealed that exposure to very early and intensive mobilization was independently associated with good functional outcome on the Barthel Index at 3 months (P=0.008) and on the Rivermead Motor Assessment at 3 (P=0.050) and 12 (P=0.024) months.
CONCLUSIONS: earlier and more intensive mobilization after stroke may fast-track return to unassisted walking and improve functional recovery. Clinical Trial Registration- This trial was not registered because enrollment began before July 2005.
Toby B Cumming; Amanda G Thrift; Janice M Collier; Leonid Churilov; Helen M Dewey; Geoffrey A Donnan; Julie Bernhardt
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Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-12-09
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-28     Completed Date:  2011-01-28     Revised Date:  2011-06-10    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  153-8     Citation Subset:  IM    
Florey Neuroscience Institute, Australia.
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MeSH Terms
Aged, 80 and over
Brain Infarction / rehabilitation*
Early Ambulation*
Intracranial Hemorrhages / rehabilitation*
Multivariate Analysis
Prospective Studies
Time Factors
Comment In:
Stroke. 2011 May;42(5):e375   [PMID:  21474809 ]
Stroke. 2011 May;42(5):e376   [PMID:  21454814 ]

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