Scott M Arnold1, Maryane Dinkins1, Lesia H Mooney2, William D Freeman3, Bhupendra Rawal4, Michael G Heckman4, Olivia A Davis5. 1. Department of Rehabilitative Services, Mayo Clinic, Jacksonville, Florida. 2. Department of Nursing, Mayo Clinic, Jacksonville, Florida. 3. Department of Neurology, Mayo Clinic, Jacksonville, Florida; Department of Critical Care, Mayo Clinic, Jacksonville, Florida; Division of Neurosurgery, Mayo Clinic, Jacksonville, Florida. 4. Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida. 5. Department of Rehabilitative Services, Mayo Clinic, Jacksonville, Florida. Electronic address: davis.olivia@mayo.edu.
Abstract
BACKGROUND: There are limited prospective data on the relative safety of very early mobilization of stroke patients after intravenous recombinant tissue plasminogen activator (IV rtPA) in stroke patients. We hypothesized that very early patient mobilization within 24 hours after IV rtPA administration for acute ischemic stroke would be safe and feasible. METHODS: The study was a prospective observational safety and feasibility study involving very early mobilization of stroke patients by physical therapy/occupational therapy within 24 hours after IV rtPA administration for treatment of ischemic stroke. A premobilization safety checklist was completed before mobilization to ensure hemodynamic stability. We assessed adverse safety events, including changes in patient symptoms, changes in vital signs, and bleeding complications. RESULTS: Eighteen patients were enrolled in the study, and informed consent was obtained. One hundred percent of patients were evaluated with a premobilization safety checklist; 72.2% (13 of 18) were mobilized without any adverse event. Eighty-nine percent (42 of 47) of mobilization activities were tolerated without an adverse response. One patient was orthostatic, and 1 patient had transient worsening of hemiparesis. No patient had intracranial bleeding or permanent worsening of neurologic deficits. CONCLUSIONS: Very early mobilization within 24 hours of ischemic stroke for patients who receive IV rtPA appears to be relatively safe and feasible in most patients. Patients who are mobilized within 24 hours of IV rtPA require detailed neurologic and vital sign monitoring.
BACKGROUND: There are limited prospective data on the relative safety of very early mobilization of strokepatients after intravenous recombinant tissue plasminogen activator (IV rtPA) in strokepatients. We hypothesized that very early patient mobilization within 24 hours after IV rtPA administration for acute ischemic stroke would be safe and feasible. METHODS: The study was a prospective observational safety and feasibility study involving very early mobilization of strokepatients by physical therapy/occupational therapy within 24 hours after IV rtPA administration for treatment of ischemic stroke. A premobilization safety checklist was completed before mobilization to ensure hemodynamic stability. We assessed adverse safety events, including changes in patient symptoms, changes in vital signs, and bleeding complications. RESULTS: Eighteen patients were enrolled in the study, and informed consent was obtained. One hundred percent of patients were evaluated with a premobilization safety checklist; 72.2% (13 of 18) were mobilized without any adverse event. Eighty-nine percent (42 of 47) of mobilization activities were tolerated without an adverse response. One patient was orthostatic, and 1 patient had transient worsening of hemiparesis. No patient had intracranial bleeding or permanent worsening of neurologic deficits. CONCLUSIONS: Very early mobilization within 24 hours of ischemic stroke for patients who receive IV rtPA appears to be relatively safe and feasible in most patients. Patients who are mobilized within 24 hours of IV rtPA require detailed neurologic and vital sign monitoring.
Authors: Rebekah A Yataco; Scott M Arnold; Suzanne M Brown; W David Freeman; C Carmen Cononie; Michael G Heckman; Luke W Partridge; Craig M Stucky; Laurie N Mellon; Jennifer L Birst; Kristien L Daron; Martha H Zapata-Cooper; Danton M Schudlich Journal: Neurocrit Care Date: 2019-04 Impact factor: 3.210
Authors: Björn Reuter; Christoph Gumbinger; Tamara Sauer; Horst Wiethölter; Ingo Bruder; Curt Diehm; Peter A Ringleb; Werner Hacke; Michael G Hennerici; Rolf Kern Journal: BMC Neurol Date: 2016-11-16 Impact factor: 2.474