Rehabilitation through early mobilization in post stroke patients
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Published:
Jul 18, 2025
Keywords:
Stroke, early mobilization, functional recovery, combination therapy
Main Article Content
Abstract
Introduction: The research was conducted through a bibliographic analysis about the application of early mobilization as a physiotherapeutic method in post cerebrovascular accident (CVA) patients. This clinical condition is described as a syndrome characterized by the rapid development of signs of neurological involvement lasting more than 24 hours. Objective: To describe the effects of rehabilitation through early mobilization in post-stroke patients to prevent musculoskeletal deterioration and favor the patient's physical recovery. Methodology: The methodology is retrospective, since a search and compilation of information was conducted by reviewing files, documents, and relevant publications. To improve this search, advanced research tools were used, such as academic databases. The study started with a population of 120 articles, and after its analysis, a sample of 25 articles was obtained, covering rehabilitation through early mobilization. Results: 36% of the studies reported significant improvements in functional capacity by increasing cerebral blood flow after early mobility even before 24 hours of stroke onset, while 12% showed that the combination with early occupational therapy, virtual reality or robot program is also beneficial in terms of mobility and functional capacity. Conclusions: The integration of Early Mobilization with occupational therapy, virtual reality or with a robot program indicating superior results compared to the application of these therapies by individual. General area of study: Physiotherapy. Specific area of study: Stroke. Type of study: Bibliographic review.
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Cuenca Jiménez, J. A., Calvopiña Caizahuano, V. E., Rodriguez Bermeo, E. A., & Barreno Gadvay, A. D. (2025). Rehabilitation through early mobilization in post stroke patients. Anatomía Digital, 8(3), 105-127. https://doi.org/10.33262/anatomiadigital.v8i3.3463
Section
Articulos de revisión bibliográfica
References
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5. Church G, Smith C, Ali A, Sage K. What is intensity and how can it benefit exercise intervention in people with stroke? A rapid review. Frontiers in Rehabilitation Sciences [Online]. 2021[cited 2025 May 28]; 2:722668. Available form: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397782/
6. Alessandro L, Olmos LE, Bonmico L, Muzio DM, Ahumada MH, Russo MJ, et al. Multidisciplinary rehabilitation for adult patients with stroke. Medicina [Online]. 2020 [cited 2025 May 28]; 80(1) 54-68. Available from: https://www.scielo.org.ar/scielo.php?script=sci_abstract&pid=S002576802020000100008&lng=es&nrm=iso&tlng=es
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14. Kuriakose D, Xiao Z. Pathophysiology, and treatment of stroke: present status and future perspectives. International Journal of Molecular Sciences [Online]. 2020 [cited 2025 May 18]; 21(20):7609. Available from: https://doi.org/10.3390/ijms21207609
15. Murphy SJX, Werring DJ. Stroke: causes and clinical features. Medicine [Online]. 2020 [cited 2025 May 28]; 48(9):561-566. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409792/
16. Hillis AE. Developments in treating nonmotor symptoms of stroke.
Expert Review of Neurotherapeutics [Online]. 2020 [cited 2025 May 20];20(6):567-576. Available from: https://doi.org/10.1080/14737175.2020.1763173
17. Yen HC, Chuang HJ, Hsiao WL, Tsai YC, Hsu PM, Chen WS, et al. Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial. Critical Care [Online]. 2024 [cited 2025 May 28];28(172). Available from: https://doi.org/10.1186/s13054-024-04940-0
18. Pigretti SG, Alet MJ, Zurrú MC. Observaciones acerca del consenso sobre accidente cerebrovascular isquémico agudo. Medicina [Internet]. 2019 [citado 28 mayo 2025];79(4):333-334. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31487263/
19. Anjos JM, Gomes Neto M, Tapparelli YA, Tse G, Zoccai G, Lima Bitar YS, et al. Efficacy and safety of very early mobilization after thrombolysis in acute ischemic stroke: a randomized clinical trial. Journal of Neurology [Online]. 2022 [cited 2025 May 28];270(2):843-850. Available from: https://doi.org/10.1007/s00415-022-11411-5
20. Nydahl P, Jeitziner MM, Vater V, Silvarajah S, Howroyd F, McWilliams D, et al. Early mobilization for prevention and treatment of delirium in critically ill patients: Systematic review and meta-analysis. Intensive and Critical Care Nursing [Online]. 2023 [cited 2025 May 28]; 74:103334. Available from: https://doi.org/10.1016/j.iccn.2022.103334
21. Penas CF de las, Ortiz AM. Cinesiterapia: bases fisiológicas y aplicación práctica [Internet]. Elsevier Health Sciences; 2019 [citado 28 mayo 2025]. Disponible en: https://books.google.com.ec/books?id=2ASWDwAAQBAJ&printsec=frontcover
22. García-Pérez P, Rodríguez-Martínez MC, Gallardo-Tur A, Blanco-Reina E, Cruz-Cosme C, Lara JP. Early Occupational Therapy Intervention post-stroke (EOTIPS): a randomized controlled trial. PLOS ONE [Online]. 2024 [cited 2025 May 28]; 19(8): e0308800. Available from: https://doi.org/10.1371/journal.pone.0308800
23. Kóra S, Bíro A, Prontvai N, Androsics M, Drotár I, Prukner P, et al. Investigation of the effectiveness of the robotic restore soft exoskeleton in the development of early mobilization, walking, and coordination of stroke patients: a randomized clinical trial. Robotics [Online] 2024[cited 2025 May 28]; 13(3):44. Available from: https://doi.org/10.3390/robotics13030044
24. Jarrín Anchundia PS. Movilización temprana del paciente de cuidados intensivos. Acta Médica Grupo Ángeles [Internet], 2022 [citado 28 mayo 2025], 20(3), 255-257. Disponible en: https://www.scielo.org.mx/scielo.php?pid=S1870-72032022000300255&script=sci_abstract
25. Zheng Y, Yan C, Shi H, Niu Q, Liu Q, Lu S, et al. Time window for ischemic stroke first mobilization effectiveness: protocol for an investigator-initiated prospective multicenter randomized 3-Arm Clinical Trial. Physical Therapy & Rehabilitation Journal [Online]. 2021 [cited 2025 May 28];101(5): pzab038. Available from: https://doi.org/10.1093/ptj/pzab038
26. Lin RC, Chiang SL, Heitkemper MM, Weng SM, Lin CF, Yang FC, et al. Effectiveness of early rehabilitation combined with virtual reality training on muscle strength, mood state, and functional status in patients with acute stroke: a randomized controlled trial. Worldviews on Evidence-Based Nursing [Online]. 2020 [cited 2025 May 28]; 17(2):158-167. Available from: https://doi.org/10.1111/wvn.12429
27. Liu L, Lu Y, Bi Q, Fu W, Zhou X, Wang J. Effects of different intervention time points of early rehabilitation on patients with acute ischemic stroke: a single-center, randomized control study. BioMed Research International [Online]. 2024 [cited 2025 May 28]. Available from: https://doi.org/10.1155/2021/1940549
28. Rahayu UB, Wibowo S, Setyopranoto I. The effectiveness of early mobilization time on balance and functional ability after ischemic stroke. Open Access Macedonian Journal of Medical Sciences [Online]. 2019 [cited 2025 May 28];7(7):1088-1092. Available from: https://pubmed.ncbi.nlm.nih.gov/31049086/
29. Yen HC, Jeng JS, Pan GS, Chuang WY, Lee YY, Teng T, et al. Early Mobilization of mild-moderate intracerebral hemorrhage patients in a stroke center: a randomized controlled trial. Neurorehabilitation and Neural Repair [Online]. 2019 [cited 2025 May 28]; 34(1):72-81. Available from: https://doi.org/10.1177/1545968319893294
30. Wang F, Zhang S, Zhou F, Zhao M, Zhao H. Early physical rehabilitation therapy between 24 and 48 h following acute ischemic stroke onset: a randomized controlled trial. Disability and Rehabilitation [Online]. 2022 [cited 2025 May 28];44(15):3967-3972. Available from: https://doi.org/10.1080/09638288.2021.1897168
31. Oommen B, Koju S. Effects of very early mobilization on motor recovery following acute stroke: a Randomized control trial. International Journal of Medical and Exercise Science [Online]. 2020 [cited 2025 May 28]; 6(4): 854-868. Available from: https://doi.org/10.36678/IJMAES.2020.V06I04.003
32. Wu WX, Zhou CY, Wang ZW, Chen GQ, Chen XL, Jin Hm, et al. Effect of early and intensive rehabilitation after ischemic stroke on functional recovery of the lower limbs: a pilot, randomized trial. Journal of Stroke and Cerebrovascular Diseases [Online]. 2020 [cited 2025 May 28]; 29(5):104649. Available from: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104649
33. Tong Y, Cheng Z, Rajah GB, Duan H, Cai L, Zhang N, et al. High Intensity physical rehabilitation later than 24h post stroke is beneficial in patients: a pilot Randomized Controlled Trial (RCT) study in mild to moderate ischemic Stroke. Frontiers in Neurology [Online]. 2019 [cited 2025 May 28]; 10:113. Available from: https://doi.org/10.3389/fneur.2019.00113
34. Cumming TB, Bernhardt J, Lowe D, Collier J, Dewey H, Langhorne P, et al. Early mobilization after stroke is not associated with cognitive outcome: Findings from AVERT. Stroke [Online]. 2018 [cited 2025 May 28]; 49(9):2147-2154. Available from: https://doi.org/10.1161/STROKEAHA.118.022217
35. Yelnik AP, Quintaine V, Andriantsifanetra C, Wannepain M, Riner P, Marnef H, et al. AMOBES (Active Mobility Very Early After Stroke): a randomized controlled trial. Stroke [Online]. 2016 [cited 2025 May 28];48(2):400-405. Available from: https://doi.org/10.1161/STROKEAHA.116.014803
36. Herisson F, Godard S, Volteau C, Le Blanc E, Guillon B, Gaudron M. Early Sitting in Ischemic Stroke Patients (SEVEL): A Randomized Controlled Trial. PLOS ONE [Online]. 2016 [cited 2025 May 28];11(3): e0149466. Available from: https://doi.org/10.1371/journal.pone.0149466
37. Morreale M, Marchione P, Pili A, Lauta A, Catiglia SF, Spallone A, et al. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach? European Journal of Physical and Rehabilitation Medicine [Online]. 2016 [cited 2025 May 28];52(1):81-89. Available from: https://pubmed.ncbi.nlm.nih.gov/26220327/
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2. Piloto CA, Suarez RB, Belaunde CA. La enfermedad cerebrovascular y sus factores de riesgo. Revista Cubana de Medicina Militar [Internet]. 2020 [citado 28 mayo 2025];49(3): e0200568. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=101993
3. Muñoz Boje R, Calvo-Muñoz I. Efectos de la terapia de realidad virtual en el miembro superior en pacientes con ictus: revisión sistemática. Rehabilitación [Internet]. 2018 [citado 28 mayo 2025]; 52(1):45–54. Disponible en: http://dx.doi.org/10.1016/j.rh.2017.09.001
4. Fure B, Holte HH, Hov L, Gunn EV, Kateraas LH, Indredavik B. Very early mobilization in cases of acute stroke. Tidsskr Nor Laegeforen [Online]. 2018 [cited 2025 May 28]; 138(17). Available from: https://tidsskriftet.no/2018/10/originalartikkel/veldig-tidlig-mobilisering-ved-akutthjerneslag
5. Church G, Smith C, Ali A, Sage K. What is intensity and how can it benefit exercise intervention in people with stroke? A rapid review. Frontiers in Rehabilitation Sciences [Online]. 2021[cited 2025 May 28]; 2:722668. Available form: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9397782/
6. Alessandro L, Olmos LE, Bonmico L, Muzio DM, Ahumada MH, Russo MJ, et al. Multidisciplinary rehabilitation for adult patients with stroke. Medicina [Online]. 2020 [cited 2025 May 28]; 80(1) 54-68. Available from: https://www.scielo.org.ar/scielo.php?script=sci_abstract&pid=S002576802020000100008&lng=es&nrm=iso&tlng=es
7. Núñez-González S, Duplat A, Simancas D. Mortalidad por enfermedades cerebrovasculares en Ecuador 2001- 2015: Estudio de tendencias, aplicación del modelo de regresión joinpoint. Revista Ecuatoriana de Neurología [Internet]. 2018 [citado 28 mayo 2025]; 27(1)16-22. Available from: http://scielo.senescyt.gob.ec/scielo.php?script=sci_abstract&pid=S263125812018000100016&lng=es&nrm=iso&tlng=es
8. Crossman AR, Neary D. Neuroanatomía. Texto y atlas en color [Internet]. Elsevier Health Sciences; 2019 [citado 28 mayo 2025]. Disponible en: https://shop.elsevier.com/books/neuroanatomia-texto-y-atlas-en-color/crossman/978-84-9113-570-8
9. Wei X, Sun S, Zhang M, Zhao Z. A systematic review and meta-analysis of clinical efficacy of early and late rehabilitation interventions for ischemic stroke. BMC Neurology [Online]. 2024 [cited 2025 May 28]; 24(91). Available from: https://doi.org/10.1186/s12883-024-03565-8
10. Feske SK. Ischemic stroke. The American Journal of Medicine [Online]. 2021 [cited 2025 May 28]; 134(12):1457-1464. Available from: https://doi.org/10.1016/j.amjmed.2021.07.027
11. Barthels D, Das H. Current advances in ischemic stroke research and therapies. Biochimica et Biophysica Acta. Molecular basis of disease [Online]. 2020 [cited 2025 May 28]; 1866(4):165260. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6981280/
12. Latarjet M, Liard AR. Anatomía Humana [Internet]. Médica Panamericana S.A; 2019[citado 28 mayo 2025]. Disponible en: https://books.google.co.ve/books?id=Gn64RKVTw0cC&printsec=frontcover&hl=es#v=onepage&q&f=false
13. García Alfonso C, Martínez Reyes A, García V, Ricaurte-Fajardo A, Torres I, Coral J. Actualización en diagnóstico y tratamiento del ataque cerebrovascular isquémico agudo. Universitas Medica [Internet]. 2019 [citado 28 mayo 2025]; 60(3): 41-57. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S2011-08392019000300041
14. Kuriakose D, Xiao Z. Pathophysiology, and treatment of stroke: present status and future perspectives. International Journal of Molecular Sciences [Online]. 2020 [cited 2025 May 18]; 21(20):7609. Available from: https://doi.org/10.3390/ijms21207609
15. Murphy SJX, Werring DJ. Stroke: causes and clinical features. Medicine [Online]. 2020 [cited 2025 May 28]; 48(9):561-566. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409792/
16. Hillis AE. Developments in treating nonmotor symptoms of stroke.
Expert Review of Neurotherapeutics [Online]. 2020 [cited 2025 May 20];20(6):567-576. Available from: https://doi.org/10.1080/14737175.2020.1763173
17. Yen HC, Chuang HJ, Hsiao WL, Tsai YC, Hsu PM, Chen WS, et al. Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial. Critical Care [Online]. 2024 [cited 2025 May 28];28(172). Available from: https://doi.org/10.1186/s13054-024-04940-0
18. Pigretti SG, Alet MJ, Zurrú MC. Observaciones acerca del consenso sobre accidente cerebrovascular isquémico agudo. Medicina [Internet]. 2019 [citado 28 mayo 2025];79(4):333-334. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31487263/
19. Anjos JM, Gomes Neto M, Tapparelli YA, Tse G, Zoccai G, Lima Bitar YS, et al. Efficacy and safety of very early mobilization after thrombolysis in acute ischemic stroke: a randomized clinical trial. Journal of Neurology [Online]. 2022 [cited 2025 May 28];270(2):843-850. Available from: https://doi.org/10.1007/s00415-022-11411-5
20. Nydahl P, Jeitziner MM, Vater V, Silvarajah S, Howroyd F, McWilliams D, et al. Early mobilization for prevention and treatment of delirium in critically ill patients: Systematic review and meta-analysis. Intensive and Critical Care Nursing [Online]. 2023 [cited 2025 May 28]; 74:103334. Available from: https://doi.org/10.1016/j.iccn.2022.103334
21. Penas CF de las, Ortiz AM. Cinesiterapia: bases fisiológicas y aplicación práctica [Internet]. Elsevier Health Sciences; 2019 [citado 28 mayo 2025]. Disponible en: https://books.google.com.ec/books?id=2ASWDwAAQBAJ&printsec=frontcover
22. García-Pérez P, Rodríguez-Martínez MC, Gallardo-Tur A, Blanco-Reina E, Cruz-Cosme C, Lara JP. Early Occupational Therapy Intervention post-stroke (EOTIPS): a randomized controlled trial. PLOS ONE [Online]. 2024 [cited 2025 May 28]; 19(8): e0308800. Available from: https://doi.org/10.1371/journal.pone.0308800
23. Kóra S, Bíro A, Prontvai N, Androsics M, Drotár I, Prukner P, et al. Investigation of the effectiveness of the robotic restore soft exoskeleton in the development of early mobilization, walking, and coordination of stroke patients: a randomized clinical trial. Robotics [Online] 2024[cited 2025 May 28]; 13(3):44. Available from: https://doi.org/10.3390/robotics13030044
24. Jarrín Anchundia PS. Movilización temprana del paciente de cuidados intensivos. Acta Médica Grupo Ángeles [Internet], 2022 [citado 28 mayo 2025], 20(3), 255-257. Disponible en: https://www.scielo.org.mx/scielo.php?pid=S1870-72032022000300255&script=sci_abstract
25. Zheng Y, Yan C, Shi H, Niu Q, Liu Q, Lu S, et al. Time window for ischemic stroke first mobilization effectiveness: protocol for an investigator-initiated prospective multicenter randomized 3-Arm Clinical Trial. Physical Therapy & Rehabilitation Journal [Online]. 2021 [cited 2025 May 28];101(5): pzab038. Available from: https://doi.org/10.1093/ptj/pzab038
26. Lin RC, Chiang SL, Heitkemper MM, Weng SM, Lin CF, Yang FC, et al. Effectiveness of early rehabilitation combined with virtual reality training on muscle strength, mood state, and functional status in patients with acute stroke: a randomized controlled trial. Worldviews on Evidence-Based Nursing [Online]. 2020 [cited 2025 May 28]; 17(2):158-167. Available from: https://doi.org/10.1111/wvn.12429
27. Liu L, Lu Y, Bi Q, Fu W, Zhou X, Wang J. Effects of different intervention time points of early rehabilitation on patients with acute ischemic stroke: a single-center, randomized control study. BioMed Research International [Online]. 2024 [cited 2025 May 28]. Available from: https://doi.org/10.1155/2021/1940549
28. Rahayu UB, Wibowo S, Setyopranoto I. The effectiveness of early mobilization time on balance and functional ability after ischemic stroke. Open Access Macedonian Journal of Medical Sciences [Online]. 2019 [cited 2025 May 28];7(7):1088-1092. Available from: https://pubmed.ncbi.nlm.nih.gov/31049086/
29. Yen HC, Jeng JS, Pan GS, Chuang WY, Lee YY, Teng T, et al. Early Mobilization of mild-moderate intracerebral hemorrhage patients in a stroke center: a randomized controlled trial. Neurorehabilitation and Neural Repair [Online]. 2019 [cited 2025 May 28]; 34(1):72-81. Available from: https://doi.org/10.1177/1545968319893294
30. Wang F, Zhang S, Zhou F, Zhao M, Zhao H. Early physical rehabilitation therapy between 24 and 48 h following acute ischemic stroke onset: a randomized controlled trial. Disability and Rehabilitation [Online]. 2022 [cited 2025 May 28];44(15):3967-3972. Available from: https://doi.org/10.1080/09638288.2021.1897168
31. Oommen B, Koju S. Effects of very early mobilization on motor recovery following acute stroke: a Randomized control trial. International Journal of Medical and Exercise Science [Online]. 2020 [cited 2025 May 28]; 6(4): 854-868. Available from: https://doi.org/10.36678/IJMAES.2020.V06I04.003
32. Wu WX, Zhou CY, Wang ZW, Chen GQ, Chen XL, Jin Hm, et al. Effect of early and intensive rehabilitation after ischemic stroke on functional recovery of the lower limbs: a pilot, randomized trial. Journal of Stroke and Cerebrovascular Diseases [Online]. 2020 [cited 2025 May 28]; 29(5):104649. Available from: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104649
33. Tong Y, Cheng Z, Rajah GB, Duan H, Cai L, Zhang N, et al. High Intensity physical rehabilitation later than 24h post stroke is beneficial in patients: a pilot Randomized Controlled Trial (RCT) study in mild to moderate ischemic Stroke. Frontiers in Neurology [Online]. 2019 [cited 2025 May 28]; 10:113. Available from: https://doi.org/10.3389/fneur.2019.00113
34. Cumming TB, Bernhardt J, Lowe D, Collier J, Dewey H, Langhorne P, et al. Early mobilization after stroke is not associated with cognitive outcome: Findings from AVERT. Stroke [Online]. 2018 [cited 2025 May 28]; 49(9):2147-2154. Available from: https://doi.org/10.1161/STROKEAHA.118.022217
35. Yelnik AP, Quintaine V, Andriantsifanetra C, Wannepain M, Riner P, Marnef H, et al. AMOBES (Active Mobility Very Early After Stroke): a randomized controlled trial. Stroke [Online]. 2016 [cited 2025 May 28];48(2):400-405. Available from: https://doi.org/10.1161/STROKEAHA.116.014803
36. Herisson F, Godard S, Volteau C, Le Blanc E, Guillon B, Gaudron M. Early Sitting in Ischemic Stroke Patients (SEVEL): A Randomized Controlled Trial. PLOS ONE [Online]. 2016 [cited 2025 May 28];11(3): e0149466. Available from: https://doi.org/10.1371/journal.pone.0149466
37. Morreale M, Marchione P, Pili A, Lauta A, Catiglia SF, Spallone A, et al. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach? European Journal of Physical and Rehabilitation Medicine [Online]. 2016 [cited 2025 May 28];52(1):81-89. Available from: https://pubmed.ncbi.nlm.nih.gov/26220327/
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