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Stroke
|December 24, 2016
PubMed
Summary

Very early intensive physical therapy (PT) after stroke did not significantly improve motor control recovery. This finding suggests intensive PT may not be beneficial for patients with severe strokes, even when initiated within the first 72 hours.

Keywords:
acute strokeexercise therapyphysical therapyrehabilitationstroke

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Clinical Trials

Background:

  • Subacute stroke recovery is often facilitated by intensive physical therapy (PT).
  • The efficacy of initiating PT extremely early, within the first two weeks post-stroke, remains less understood.
  • Investigating very early intensive PT is crucial for optimizing stroke rehabilitation protocols.

Purpose of the Study:

  • To determine if intensive PT initiated within 72 hours of a first hemispheric stroke improves motor control recovery.
  • To compare the effects of standard PT versus intensive PT on motor function, walking ability, balance, and autonomy.

Main Methods:

  • A multicentre randomized controlled trial comparing soft PT (20 min/day) with intensive PT (20 min + 45 min exercises/day).
  • Intervention initiated within 72 hours post-stroke.
  • Primary outcome: change in Fugl-Meyer score at 90 days; secondary outcomes included time to unassisted walking, balance, and quality of life.

Main Results:

  • Motor control, assessed by the Fugl-Meyer score, improved significantly over time in both groups (P<0.0001).
  • No significant difference in motor control improvement was observed between the intensive PT and soft PT groups (P=0.29).
  • Secondary outcomes related to walking, balance, and autonomy also showed no significant differences between the groups.

Conclusions:

  • Initiating intensive physical therapy within the first 72 hours after stroke does not appear to enhance motor control recovery.
  • The findings suggest that very early intensive PT may not be effective, particularly for patients with severe strokes.
  • Further research may be needed to identify optimal timing and intensity for PT in different stroke severity groups.