Introduction

This systematic review and meta-analysis assessed the effects of initiating rehabilitation early on clinical outcomes in patients diagnosed with acute stroke.

Material and methods

A comprehensive search across five prominent databases was performed, including all available records from database inception until January 31, 2024. Statistical computations were conducted using Review Manager software (version 5.3).

Results

Twelve studies involving 5,167 participants were incorporated. Aggregated findings indicated that early rehabilitation resulted in a statistically significant improvement in activities of daily living compared to the control condition (mean difference [MD] = 6.07, 95% confidence interval [CI]: 2.24-9.89, p = 0.002). In contrast, no statistically significant differences were observed between groups for National Institutes of Health Stroke Scale scores (MD = 0.42, 95% CI: –2.21-1.37, p = 0.65) or mortality rates (odds ratio [OR] = 0.85, 95% CI: 0.35-2.06, p = 0.71). A qualitative summary of quality of life data suggested that early rehabilitation had a more marked positive influence on the ‘independent living’ facet. The overall quality of life scores, however, were not significantly different.

Conclusions

In individuals with acute stroke, early rehabilitation was associated with improved functional recovery at three months, primarily reflected in improved daily functioning and specific quality-of-life areas. Its influence on reducing mortality and improving neurological impairment, however, was not established and requires further study.