The Effectiveness of Early Mobilization for Acute Ischemic Stroke Treated With Rt-PA or IA Thrombectomy
Condition: Acute Ischemic Stroke
MeSH terms: Stroke; Ischemic Stroke; Ischemia
Study type: Interventional

Summary: 
      The purpose of the study will to test the hypothesis that combining early out-of-bed
      mobilization within 72 hours of stroke onset with treated by intravenous recombinant
      tissue-type plasminogen activator (IV-rtPA) or endovascular thrombectomy (ET) would result in
      a greater benefit than standard early rehabilitation within 72 hours of stroke onset with
      treated by IV-rtPA or ET.
    

Detailed description: 
      The treatments for acute ischemic stroke have evolved rapidly in recent years including
      intravenous (IV) thrombolysis using recombinant tissue-type plasminogen activator (rtPA) and
      endovascular thrombectomy (ET). Those new interventions constitute a landmark change in
      stroke treatment. Since early mobilizing patients after stroke as early as possible might
      prevent immobility-related complications and promote brain recovery, previous studies
      supported that early mobilization should commence at some point within 72 hours of stroke.
      However, increased risk of symptomatic intracerebral hemorrhage or ischemia-reperfusion
      injury underlies concerns early mobilization of patients treated with rtPA or ET. Bedside, a
      limited amount of research has investigated what specific timing for starting early
      mobilization after intravenous IV rtPA or ET would optimize recovery potential during the
      acute period after cerebral infarction. Further research is needed to understand whether the
      outcomes resulting from starting mobilization within 72 hours of onset for a stroke treated
      with rtPA or ET is better than that of starting mobilization later. Therefore, the purpose of
      the study will to test the hypothesis that combining early out-of-bed mobilization within 72
      hours of stroke onset with treated by IV rtPA or ET would result in a greater benefit than
      standard early rehabilitation within 72 hours of stroke onset with treated by IV rtPA or ET.
    

Intervention name(s): standard early rehabilitation; adding early out-of-bed mobilization
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The standard early rehabilitation program is an intervention regularly utilized in the stroke center of National Taiwan University Hospital. Activities performed in the standard early rehabilitation program within 24-72 hours of onset include(1) bed exercises including the joint range of motion exercise, bridge exercise, the straight leg raising exercise, stretching exercises, and facilitation techniques, and (2) functional training in which the patients are instructed to engage in the repetitive and systematic practice of tasks, such as rolling or sitting supported on the bed.; Early mobilization treatment involving out-of-bed, task-specific activities including rolling and sitting up, sitting unsupported out of bed, and standing within 24-72 hours of onset and accounting for more than two thirds of the treatment time in early rehabilitation .
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Ischemic Stroke; Acute; Early intervention; Mobilization