Early versus delayed rehabilitation treatment in hemiplegic XXXX with @entity385 : proprioceptive or @entity73 ?

@entity1 @entity1158 @entity64 @entity308 @entity73 @entity385
BACKGROUND: Early/intensive mobilization may improve functional recovery after @entity64 but it is not clear which kind of "mobilization" is more effective. Proprioceptive neuromuscular facilitation (PNF) and @entity73 ( @entity73 ) are widespread applied in post- @entity64 rehabilitation but their efficacy and safety have not been systematically investigated. AIM: To compare PNF and @entity73 methods in a two different time setting (early versus standard approach) in order to evaluate different role of time and techniques in functional recovery after acute @entity385 . DESIGN: We designed a prospectical multicenter blinded interventional study of early versus standard approach with two different methods by means of both PNF and @entity73 . SETTING: A discrete @entity64 -dedicated area for out-of-thrombolysis @entity1 , connected with two different @entity64 centres in two different catchment areas. POPULATION: Three hundred and forty consecutive @entity64 @entity1 with first ever sub-cortical @entity385 in the mean cerebral artery (MCA) territory and contralateral @entity1158 admitted within 6 and 24 hours from symptoms onset. METHODS: All @entity1 were randomly assigned by means of a computer generated randomization sequence in blocks of 4 to one to the 4 interventional groups: early versus delayed rehabilitation programs with Kabat's schemes or Perfetti's technique. @entity1 in both delayed group underwent to a standard protocol in the acute phase. PRIMARY OUTCOME: disability at 3-12 months. Disability measures: modified Rankin Score and Barthel Index. Safety outcome: immobility-related adverse events. SECONDARY OUTCOME MEASURES: Six-Minute Walking Test, Motricity Index, Mini-Mental State Examination, Beck @entity308 Inventory. RESULTS: Disability was not different between groups at 3 months but Barthel Index significantly changed between early versus delayed groups at 12 months (P=0.01). Six-Minute Walking Test (P=0.01) and Motricity Index in both upper (P=0.01) and lower limbs (P=0.001) increased in early versus delayed groups regardless rehabilitation schedule. CONCLUSIONS: A time-dependent effect of rehabilitation on post @entity64 motor recovery was observed, particularly in lower limb improvement. According to our results, rehabilitation technique seems not to affect long term motor recovery. CLINICAL REHABILITATION IMPACT: These results show a significant effect of time but not of technique that may impact the decision making in the acute phase of care.
