Background: The effect of early mobilization after acute stroke is still unclear, although some studies have suggested improvement in outcomes. We conducted a randomized, single-blind, controlled trial seeking to evaluate the feasibility, safety, and benefit of early mobilization for patients with acute ischemic stroke treated in a public teaching hospital in Southern Brazil. This report presents the feasibility and safety findings for the pilot phase of this trial. Methods: The primary outcomes were time to first mobilization, total duration of mobilization, complications during early mobilization, falls within 3 months, mortality within 3 months, and medical complications of immobility. We included adult patients with CT- or MRI-confirmed ischemic stroke within 48 h of symptom onset who were admitted from March to November 2012 to the acute vascular unit or general emergency unit of a large urban emergency department (ED) at the Hospital de Clínicas de Porto Alegre. The severity of the neurological deficit on admission was assessed by the National Institutes of Health Stroke Scale (NIHSS). The NIHSS and modified Rankin Scale (mRS, functional outcome) scores were assessed on day 14 or at discharge as well as at 3 months. Activities of daily living (ADL) were measured with the modified Barthel Index (mBI) at 3 months. Results: Thirty-seven patients (mean age 65 years, mean NIHSS score 11) were randomly allocated to an intervention group (IG) or a control group (CG). The IG received earlier (p = 0.001) and more frequent (p < 0.0001) mobilization than the CG. Of the 19 patients in the CG, only 5 (26%) underwent a physical therapy program during hospitalization. No complications (symptomatic hypotension or worsening of neurological symptoms) were observed in association with early mobilization. The rates of complications of immobility (pneumonia, pulmonary embolism, and deep vein thrombosis) and mortality were similar in the two groups. No statistically significant differences in functional independence, disability, or ADL (mBI ≥85) were observed between the groups at the 3-month follow-up. Conclusions: This pilot trial conducted at a public hospital in Brazil suggests that early mobilization after acute ischemic stroke is safe and feasible. Despite some challenges and limitations, early mobilization was successfully implemented, even in the setting of a large, complex ED, and without complications. Patients from the IG were mobilized much earlier than controls receiving the standard care provided in most Brazilian hospitals.

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Objetivo. Avaliar o controle de tronco e funcionalidade em pacientes hemiparéticos pós-AVC através da aplicação das escalas Escala de Deficiência de Tronco (EDT), Escala de Controle de Tronco (ECT), Escala de Avaliação da Simetria e Transferência de Peso (ASTP), Escala de Rankin Modificada (ERm) e Índice de Barthel (IB). Método. Pesquisa quantitativa do tipo transversal, com amostra de 9 indivíduos, atendidos pela fisioterapia na enfermaria do Hospital Municipal de Canoas/RS, de agosto à outubro de 2020. Os dados foram descritos por média e desvio padrão ou mediana e amplitude de variação. Para comparar medianas, o teste de Mann-Whitney foi utilizado e para correlação dos dados o teste da correlação de Spearman. Resultado. Quanto ao controle de tronco, as medianas encontradas: EDT 10 (0-23), TCT 87 (24-100) e ASTP 18 (9-27). Quanto à funcionalidade, a mediana da ERm foi 4 (0-6) e a média do IB 65±27,7 (0-100). Houve associação inversa entre as escalas de controle de tronco e a ERm (EDT p=0,019, TCT p<0,001 e ASTP p<0,001) e uma associação positiva com o IB (EDT p=0,010, TCT p<0,001 e ASTP p<0,001). Conclusão. A relação do controle de tronco com a funcionalidade demonstrou ter uma forte correlação, onde quanto melhor o controle de tronco, maior a funcionalidade.