Very early mobilisation of stroke patients may not be better than usual care

Published: Friday 17 April 2015

First results from the AVERT, early rehabilitation trial were unveiled at the European Stroke Organisation Conference (ESO) today, and also published in the journal, The Lancet.  

AVERT (A Very Early Rehabilitation Trial) is an international trial across 5 countries, including the UK. The trial tested whether a protocol of frequent, higher dose mobility training (mobilisation) started within 24 hours of stroke onset, delivered by physiotherapists and nurse working together, improved outcome at 3 months and was safe when compared with lower dose usual care stroke treatment.

Professor Julie Bernhardt, AVERT Principal Investigator, said:

"This study is the largest collaborative trial ever conducted to determine how we should approach early rehabilitation with a mobility focus after stroke."

"We ran this trial in 56 hospitals across 5 countries, recruiting over 2000 patients within 24 hours of stroke onset.” 

Professor Peter Langhorne, lead investigator on the UK arm of AVERT, said:

We found that early rehabilitation was safe, with low death and low complications rates in the vast majority of patients. This is a testament to the modern stroke unit care these patients received.”

“However we also found that patients in the early but lower dose group were more likely to make a good recovery by 3 months after stroke.”

“This tells us that we must be cautious with very early intensive rehabilitation and further exploration of the results is underway to determine which approach is best for individual patients.”

“The value of conducting this trial won’t be fully realised for some time, but the high quality of the trial and comprehensive nature of the data gathered is a testament to the commitment of the patients, families, hospital and research staff involved.” 

The results from AVERT have the potential to change and further guide clinical practice in the early post stroke period, worldwide.  

We look forward to further analyses and results from this trial in the near future.

AVERT was funded by National Health and Medical Research Council, Singapore Health, Chest Heart and Stroke Scotland, Northern Ireland Chest Heart and Stroke, The Stroke Association, and the National Institutes of Health Research.

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