Abstract WMP28: The Safety And Feasibility Of Early Mobility In Acute Ischemic Stroke Patients After IV Alteplase

Abstract

Background and Purpose: Acute stroke patients who receive intravenous (IV) alteplase have historically remained on bedrest for the first 24 hours after infusion completion. We sought to determine the safety and feasibility of mobilizing patients with low NIHSS between 6 and 24 hours post-alteplase infusion. Methods: Patients with NIHSS ≤5 after IV alteplase infusion were included. We excluded patients also undergoing mechanical thrombectomy. Subjects were stratified into an early mobilization group and a standard care group based on nursing compliance with an early mobilization protocol. Safety endpoints included falls, neurological deterioration in NIHSS (increase of ≥ 2 points), and physiological events (defined by out-of-range vital signs). Each safety endpoint was quantified for both groups. Additionally, demographic characteristics and past medical history were compared between the groups to identify any statistically significant differences (p < 0.05). Results: Between June 2020 and April 2021, 93 acute stroke patients received IV alteplase and had an NIHSS of ≤5 following thrombolytic therapy. Of the included subjects, 54 received early mobilization while 39 did not. There were no statistically significant differences in gender, race, or past medical history between the two groups. Among safety endpoints, there were no reported instances of falls, neurological deterioration in NIHSS, or significant physiological events in either group. Conclusions: Our study demonstrates that instituting early mobilization as soon as 6 hours after alteplase infusion completion is safe and feasible mild acute stroke patients. Future studies should explore efforts to increase the number of patients who receive early mobilization and investigate functional outcomes between patients receiving early mobilization compared to standard medical care.