Impact of Early Rehabilitation on Outcomes in Patients With Acute Ischemic Stroke After Endovascular Treatment

Yi He; Ximing Nie; Tao He; Xiao Qi; Zhenzhen Chen; Wei Duan; Yufei Wei; Xiran Liu; Yong Liu

doi:10.3389/fneur.2022.877773

Impact of Early Rehabilitation on Outcomes in Patients With Acute Ischemic Stroke After Endovascular Treatment

Front Neurol. 2022 May 23:13:877773. doi: 10.3389/fneur.2022.877773. eCollection 2022.

Authors

Yi He¹, Ximing Nie², Tao He³, Xiao Qi¹, Zhenzhen Chen¹, Wei Duan³, Yufei Wei², Xiran Liu², Yong Liu¹

Affiliations

¹ Department of Pain and Rehabilitation, Xinqiao Hospital, Army Medical University, Chongqing, China.
² Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
³ Department of Neurology, Xinqiao Hospital, Army Medical University, Chongqing, China.

Abstract

Background: This study aims to examine the effects of early rehabilitation on functional outcomes in patients with acute ischemic stroke treated with endovascular treatment (EVT).

Methods: Eligible patients with large vessel occlusion stroke treated with EVT, who received early rehabilitation or standard care treatment during hospitalization, were enrolled in a multicenter registration, prospective observational study, a registration study for Critical Care of Acute Ischemic Stroke After Recanalization. Early rehabilitation was defined as rehabilitation interventions initiated within 1 week after acute stroke. The primary outcome was the favorable functional outcome (defined as modified Rankin Scale scores of 0 to 2) at 90 days. Independent association between early rehabilitation and the primary outcome was investigated using multivariable logistic regression in the entire sample and in subgroups.

Results: A total of 1,126 patients (enrolled from July 2018 to May 2019) were included in the analyses, 273 (24.2%) in the early rehabilitation group and 853 (75.8%) in the standard care group. There was no significant difference in favorable functional outcomes at 90 days between the two groups (45.4 vs. 42.6%, p = 0.41). Patients in the early rehabilitation group had a lower death rate within 90 days compared with the standard care group (6.2 vs. 20.5%, p < 0.01). The multivariable logistic regression analyses showed that the early rehabilitation was not significantly associated with the favorable functional outcome at 90 days (adjusted odds ratio, 1.01 [95% CI, 0.70-1.47]; p = 0.95). There was no significant difference between subgroups in the favorable functional outcome at 90 days. No significant interaction was found between subgroups.

Conclusions: Patients with stroke receiving early rehabilitation had a lower death rate. However, these clinically meaningful effects of early rehabilitation did not show on functional outcome at 90 days in patients with large vessel occlusion stroke treated with EVT.

Registration: URL: http://www.chictr.org.cn; Unique identifier: ChiCTR1900022154.

Keywords: acute ischemic stroke; early rehabilitation; endovascular treatment; functional outcome; large vessel occlusion stroke.