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Stroke rehab must start earlier, say revised US guidelines: Why physio can begin in hospital
Confirmed
In Short: Stroke patients should start rehabilitation as soon as they are medically stable, ideally within 48 hours, according to updated guidelines from the American Stroke Association and American Heart Association.
Stroke rehabilitation should begin as soon as a patient is medically stable, ideally within 48 hours, to maximize recovery chances, according to new guidelines from the American Stroke Association and American Heart Association. This early start is crucial for addressing physical, cognitive, communication, and mental health needs.
The new guidelines, published in the American Heart Association’s peer-reviewed journal Stroke, emphasize personalized rehabilitation plans and highlight the importance of early mobilization. 'Recovery after a stroke is about more than getting stronger physically and regaining abilities,' said Lorie Richards, PhD, FAHA, who chaired the guideline writing group.
Starting rehabilitation early can improve outcomes, as supported by both animal models and human studies. Richards noted, 'There is strong evidence that rehabilitation should start early, both in animal models of stroke and in humans with stroke.' However, mobilization between 24 to 48 hours after a stroke is recommended, as earlier mobilization may not always lead to better outcomes.
Rehabilitation plays a critical role in helping stroke survivors regain independence and optimize their recovery. With nearly 800,000 people experiencing a stroke each year in the United States, these guidelines aim to improve recovery outcomes for stroke patients.
What's confirmed
- Stroke rehabilitation should begin as soon as a patient is medically stable, ideally within 48 hours, to maximize recovery chances, according to new guidelines from the American Stroke Association and American Heart Association. This early start is crucial for addressing physical, cognitive, communication, and mental health needs.
- The new guidelines, published in the American Heart Association’s peer-reviewed journal Stroke, emphasize personalized rehabilitation plans and highlight the importance of early mobilization. 'Recovery after a stroke is about more than getting stronger physically and regaining abilities,' said Lorie Richards, PhD, FAHA, who chaired the guideline writing group.
- Starting rehabilitation early can improve outcomes, as supported by both animal models and human studies. Richards noted, 'There is strong evidence that rehabilitation should start early, both in animal models of stroke and in humans with stroke.' However, mobilization between 24 to 48 hours after a stroke is recommended, as earlier mobilization may not always lead to better outcomes.
- Rehabilitation plays a critical role in helping stroke survivors regain independence and optimize their recovery. With nearly 800,000 people experiencing a stroke each year in the United States, these guidelines aim to improve recovery outcomes for stroke patients.
What's still developing
- Post-stroke depression is common, for example, but it is also treatable if identified by the patient’s care team.
- The guideline replaces recommendations issued in 2016 and reflects advances in stroke rehabilitation and recovery.
- “This guideline expands or makes new recommendations in cognition, mental health, sleep, and post-stroke fatigue, recreation and leisure,” Lorie Richards, PhD, FAHA, who chaired the guideline writing group and is an associate professor at the University of Utah and a licensed occupational therapist, told Medical News Today.
- “While all rehab should start early, it’s really important to have early mobilization. This means a structured program of sitting up in bed, moving to sitting at the side of the bed, standing and walking, with an emphasis on standing and walking as soon within this program as possible – between 24 to 48 hours after stroke,” she said.