A systematic review and meta-analysis of clinical efficacy of early and late rehabilitation interventions for ischemic stroke

Abstract

Abstract Introduction: At present, stroke has become the first cause of death and disability among Chinese adults. With the coming of the aging population in China, the disease burden brought by stroke will be increasingly aggravated. And stroke is a leading cause of disability. There is a golden plastic period after stroke, during which timely and safe intervention and rehabilitation therapy can effectively improve the disability status. However, there is still controversy about the duration of interventional rehabilitation after stroke. This study conducted a meta-analysis on the influence of intervention in early and late ischemic stroke rehabilitation. Method: Chinese language databases such as CNKI, Wanfang, and VIP, and English language databases such as PubMed, Web of Science, and The Cochrane Library were searched, and RCT related to early and late rehabilitation of ischemic stroke from the establishment of the database to May 2022 was collected. Review Manager 5.4.1 was used for relevant analysis. Results: A total of 1635 patients were included in 14 studies. The results showed that, compared with late rehabilitation, early rehabilitation improved clinical efficacy. Barthel Index or Modified Barthel Index score was [MD=8.82, 95%CI(8.21,9.43), p < 0.001]; the score of Fugl-Meyer Assessment Scale was [MD=8.75, 95%Cl (7.0,10.47), P< 0.001]; the score of NIHSS was [MD=-1.42, 95% CI(-1.93,-0.91), P<0.001]; the result of China Stroke Scale score was [MD=-3.68, 95%CI(-5.43,-1.92), P<0.001]. Conclusion: In comparison with late rehabilitation, early rehabilitation can significantly improve self-care abilities, daily activities, and neurological functions of ischemic stroke patients. Registration: This meta-analysis has been registered with Prospero, and the registration number is CRD42022309911. The registration period is March 22, 2022.