# The effect of the begining time of the rehabilitation program in stroke patients on functional ambulation and stroke related complications

## TL;DR

This study shows that starting rehabilitation early after a stroke improves walking ability and reduces complications, contrary to the belief that early rehab increases risks.

## Contribution

The study demonstrates that early rehabilitation after stroke is effective and does not increase complications, challenging existing perceptions.

## Key findings

- Early rehabilitation (0-30 days post-stroke) significantly improved functional ambulation scores compared to later initiation.
- Patients who started rehab early had fewer complications like depression, UTIs, and incontinence.
- No significant relationship was found between stroke complications and improvement in functional scores.

## Abstract

The aim of this study was to reveal the effect of rehabilitation initiation time on the functional status and complications encountered during the rehabilitation process in stroke patients who underwent rehabilitation program in the physical medicine and rehabilitation clinic of our hospital.

Patients who received outpatient and inpatient rehabilitation treatment with the diagnosis of acute stroke in the Physical Medicine and Rehabilitation Clinic of Yozgat City Hospital between January 2017 and August 2022 were screened. Patients with acute stroke and had a file record were included in the study.

Demographic information such as age, gender, comorbid diseases; type and direction of stroke, time from stroke until the rehabilitation program begins, total rehabilitation period, stroke-related complications, Brunnstrom stages, and functional ambulation scale scores of stroke patients were recorded

A total of 314 patients were included in this study and evaluated improvement in the functional ambulation scale scores according to the beginning time of the rehabilitation program. When the patients were grouped as 0-30 days, 31-60 days, and 61 days or more according to the time elapsed until the rehabilitation program, a significant difference was found in terms of the increase in FAS scores both in the pairwise comparisons and the comparison of all three groups together (p<0.001 for all comparisons). There was a moderate positive correlation between the total number of rehabilitation sessions and improvement in FAS scores (Rho=.316, p<0.01). Complications were observed in almost all patients in our study (97.7%). The comparison of the groups for stroke complications revealed that the frequency of depression, urinary tract infection, urinary incontinence, decubitus ulcer, dysphagia, convulsion, falling and aphasia was lower in the 0-30 days group compared to the other groups (p<0.01). There was also no significant correlation between the presence of stroke complications and improvement in FAS score (p>0.05).

Contrary to popular belief, we showed that early rehabilitation does not increase complications and has a positive effect on function. Despite the perception that complications would negatively affect function, there was no significant relationship between the presence of stroke complications and the improvement in FAS score. We found that the rehabilitation program applied in the early period after stroke is effective and reliable.