Langhorne, Peter, Stott, David, Knight, Anne, Bernhardt, Julie, Barer, David and Watkins, Caroline (2010) Very Early Rehabilitation or Intensive Telemetry after Stroke: A Pilot Randomised Trial. Cerebrovascular Diseases, 29 (4). pp. 352-360. ISSN 1015-9770
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Official URL: http://dx.doi.org/10.1159/000278931
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 ! 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.
|Subjects:||R Medicine > RT Nursing|
|Schools:||College of Health and Wellbeing > School of Health|
|Deposited By:||Michael Bowerman|
|Deposited On:||29 Mar 2012 19:16|
|Last Modified:||23 Jul 2015 10:55|
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