Early Mobilization after Stroke: Changes in Clinical Opinion Despite an Unchanging Evidence Base

• Published in: Journal of stroke and cerebrovascular diseases 2017-01, Vol.26 (1), p.1-6
• Main Authors: Lynch, Elizabeth A., PhD, Cumming, Toby, PhD, Janssen, Heidi, PhD, Bernhardt, Julie, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Attitude of Health Personnel; Australia; Cardiovascular; clinical opinion; Early Ambulation - methods; early mobilization; Evidence-Based Medicine; Female; Health Personnel - psychology; Humans; Intracranial Hemorrhages; Male; Middle Aged; Neurology; Outcome Assessment (Health Care); questionnaire; Retrospective Studies; Stroke; Stroke Rehabilitation; Time Factors; Young Adult
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2016.08.021

Background We sought to determine whether Australasian health professionals' opinions regarding early mobilization after stroke changed between 2008 and 2014, when a large international trial of early mobilization (A Very Early Rehabilitation Trial, AVERT) was underway. Methods Attendees at the two major Australasian stroke conferences in 2008 and 2014 were surveyed. Participants rated their agreement with statements about the risks and benefits of commencing mobilization within 24 hours of hemorrhagic and ischemic stroke using a 5-point Likert scale. Participants in 2014 were asked about their awareness of AVERT. Logistic regressions were performed to determine whether the time point (2008 versus 2014) or awareness of AVERT influenced opinions about early mobilization. Results Surveys were completed by 443 health professionals (2008: N = 202; 2014: N = 241). Most respondents in 2014 reported that early mobilization was beneficial and not harmful to people with ischemic and hemorrhagic stroke. Opinions regarding mobilization after ischemic stroke did not change significantly between 2008 and 2014. In 2014, a significantly greater proportion of respondents believed that early mobilization after hemorrhagic stroke was helpful (2008: n = 98 of 202 [49%] versus 2014: n = 170 of 241 [71%], P