title: Very early mobilization in stroke patients treated with intravenous recombinant tissue plasminogen activator.
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.
authors: Department of Rehabilitative Services, Mayo Clinic, Jacksonville, Florida.
authors: Scott M
authors: SM
authors: Arnold
authors: Department of Rehabilitative Services, Mayo Clinic, Jacksonville, Florida.
authors: Maryane
authors: M
authors: Dinkins
authors: Department of Nursing, Mayo Clinic, Jacksonville, Florida.
authors: Lesia H
authors: LH
authors: Mooney
authors: Department of Neurology, Mayo Clinic, Jacksonville, Florida; Department of Critical Care, Mayo Clinic, Jacksonville, Florida; Division of Neurosurgery, Mayo Clinic, Jacksonville, Florida.
authors: William D
authors: WD
authors: Freeman
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida.
authors: Bhupendra
authors: B
authors: Rawal
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida.
authors: Michael G
authors: MG
authors: Heckman
authors: Department of Rehabilitative Services, Mayo Clinic, Jacksonville, Florida. Electronic address: davis.olivia@mayo.edu.
authors: Olivia A
authors: OA
authors: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy*; D004434:Early Ambulation; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Early mobilization; intensive care unit; ischemic stroke; occupational therapy; physical therapy; recombinant tissue plasminogen activator