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Evidence in Action, Impact of Early Occupational Therapy Intervention in the Complex Stroke Patient, Department of Occupational Therapy, Thomas Jefferson University Hospital



Cerebrovascular disorders represent the third leading cause of mortality and second major cause of long-term disability in North America (3). Patients who arrive at the emergency room within 3 hours of their first symptoms tend to have less disability 3 months after a stroke than those who received delayed care (4). Further, several studies suggest stroke rehabilitation is most effective when initiated early, and confirms the existence of a positive correlation between early rehabilitation interventions and improved functional outcomes (2). Rationale to support these findings is centered around various arguments that bed rest negatively affects various body systems and that there may be a narrow window of opportunity for neuro plasticity. Thus, the optimum period to regain function could be early after stroke (1). Guided by these findings, early mobilization strategies have been widely adapted in intensive care units to facilitate recovery, particularly with those status post onset of stroke symptoms. Further, occupational therapy interventions, coupled with early mobilization protocols, maximizes potential for earlier admission to acute inpatient rehabilitation (4). Timely rehab admission is also associated with more favorable functional outcomes and a decreased rehab length of stay (1).