A study on additional early physiotherapy after stroke and factors affecting functional recovery

Objective: To investigate whether additional early physiotherapy after stroke improved functional recovery in stroke patients. Design: A prospective, randomized, controlled study. Setting: One stroke ward and an acute stroke unit in a large teaching hospital, southern China. Subjects: Patients with first-onset stroke consecutively admitted to the stroke centre. Interventions: One group (n = 78) received additional early physiotherapy (AEP) for 45 minutes, five days a week for four weeks starting within the first week since stroke onset; the routine therapy (RT) group (n = 78) received no professional rehabilitation therapy. Main outcome measures: Glasgow Coma Scale, Mini-Mental State Examination, Fugl-Meyer Assessment of Motor Recovery, Clinical Neurological Deficit Scale and Modified Barthel Index (MBI). Results: Patients from the AEP group had a high drop-out rate (n = 28), but those remaining made relatively better functional recovery at 30 days than those from the RT group if measured by MBI. Multiple linear regression analysis revealed that cognitive disturbance, aphasia, double incontinence, site of lesion and sensory impairment might affect functional recovery after stroke. Conclusions: Additional early physiotherapy might improve independence of patients after stroke but failed to show benefit in other aspects in our study. Cognitive disturbance, aphasia, double incontinence, site of lesion as well as sensory impairment might affect functional outcome after stroke.