Very Early Rehabilitation or Intensive Telemetry after Stroke: A Pilot Randomised Trial

Langhorne, P. , Stott, D. , Knight, A., Bernhardt, J., Barer, D. and Watkins, C. (2010) Very Early Rehabilitation or Intensive Telemetry after Stroke: A Pilot Randomised Trial. Cerebrovascular Diseases, 29(4), pp. 352-360. (doi: 10.1159/000278931)

Abstract

Background: Stroke patients are more likely to make a good recovery if they receive care in a well-organised stroke unit. However, there are uncertainties about how best to provide such care. We studied 2 key aspects of early stroke unit care: early active mobilisation (EM) and automated monitoring (AM) for physiological complications such as hypoxia. Methods: This was an observer-blinded, factorial (2 x 2) pilot randomised controlled trial recruiting stroke patients within 36 h of symptom onset. The patients were randomised to 1 of 4 nurse-led treatment protocols: (a) standard stroke unit care, (b) EM, (c) AM or (d) combined EM and AM. The primary outcome was the Rankin score at 3 months. We also report the data on feasibility and safety. Results: We randomised 32 patients (mean age = 65 years; mean baseline modified NIH score = 6). On unadjusted comparisons, the EM patients were significantly (p < 0.05) more likely to mobilise very early (within 1 h of randomisation) and to achieve walking by day 5 and were less likely to develop complications of immobility. The AM group was significantly ( p < 0.05) more likely to have pre-defined physiological complication events detected. All these associations remained, but were less statistically significant, after correcting for age, baseline NIH score and co-interventions. There were no significant safety concerns. Discussion: We have demonstrated the feasibility of implementing EM and AM for physiological complications in a randomised controlled trial. Larger trials are warranted to determine whether these interventions have clinical benefits. Copyright (C) 2010 S. Karger AG, Basel

• Item Type: Articles
• Keywords: AGE ASSOCIATION ASSOCIATIONS Automated monitoring AVERT BENEFITS CARE COMPLICATIONS CONTROLLED-TRIAL DISEASE Early active mobilization EVENTS INTERVENTION LEVEL Measurement neurology outcome PATIENT patients PHASE-II RECOVERY REHABILITATION SAFETY SCORE Scotland stroke Treatment TRIAL trials UNIT Very Early Rehabilitation or Intensive Telemetry after Stroke trial
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Langhorne, Professor Peter and Stott J, Professor David
• Authors: Langhorne, P., Stott, D., Knight, A., Bernhardt, J., Barer, D., and Watkins, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences
• Journal Name: Cerebrovascular Diseases
• ISSN: 1015-9770