Sehr frühe Mobilisation nach Schlaganfall

Zusammenfassung

Weltweit beschäftigen sich Wissenschaftler mit der Frage, wie früh man Patienten nach Schlaganfall aus dem Bett holen darf. Ein großes Programm dazu startete 2001 mit der AVERT-Studie in Australien (AVERT = A Very Early Rehabilitation Trial). Diese Studie befasst sich mit den Effekten der frühen Mobilisation und dem Weiterverlauf der Therapie im Akutkrankenhaus für die Rehabilitation von Patienten nach Schlaganfall. Julie Bernhardt, die Direktorin des AVERT-Forschungsprogramms, gibt in ihrem Artikel einen Überblick über den aktuellen Forschungsstand. Besonders interessant ist die Diskussion um den Beitrag von Tierexperimenten in der Neurorehabilitation.

Literatur

• 01 Adams H J, Adams R , Brott T  et al.. Guidelines for the early management of patients with ischemic stroke: A scientific statement from the stroke council of the American Stroke Association.  Stroke. 2003;  34 1056-1083
• 02 Aldhous P . Adding exercise to injury.  New Scientist Magazine. 1996;  151 17
• 03 Bernhardt J . Very early mobilization following acute stroke: Controversies, the unknowns and a way forward.  Annals of Indian Academy of Neurology. 2008;  11 88-98
• 04 Bernhardt J , Dewey H , Collier J  et al.. A Very Early Rehabilitation Trial (AVERT) phase II safety and feasibility results.  Stroke. 2007;  38 473
• 05 Bernhardt J , Dewey H , Donnan G  et al.. A very early rehabilitation trial (avert): Phase III (Australian Clinical Trials Registry: 1260600185561). Lancet Protocol Review: Protocol 06PRT/5424: published online July/2007: 31-66
• 06 Bernhardt J , Indredavik B , Dewey H  et al.. Mobilisation „In bed” Is not mobilisation [letter to the editor].  Cerebrovascular Diseases. 2007;  24 157-158
• 07 Bernhardt J , Legg L . Evidence-based practice: What is it, how to do it, and why should we care?. In: Lennon S , Stokes M , (Hrsg.) Pocketbook of neurological physiotherapy. Elsevier; Edinburgh; 2009
• 08 Bernhardt J , Thuy M N T, Collier J  et al.. Very early versus delayed mobilisation after stroke. Cochrane Database of Systematic Reviews; 2009 Art. Issue 1 No.: CD006187. DOI: 10.1002/14651858.CD006187.pub2
• 09 Cheeran B , Cohen L , Dobkin B  et al.. The future of restorative neurosciences in stroke: Driving the translational research pipeline from basic science to rehabilitation of people after stroke.  Neurorehabil Neural Repair. 2009;  23 97-107
• 10 Cramer S C. The EXCITE trial: A major step forward for restorative therapies in stroke.  Stroke. 2007;  38 2204-2205
• 11 Cumming T B, Collier J , Thrift A G et al.. The effect of very early mobilisation after stroke on psychological well-being.  Journal of Rehabilitation Medicine. 2008;  40 609-614
• 12 Cumming T, Thrift A, Collier J  et al.. Very early mobilisation after stroke fast tracks return to walking: Further results from a randomised controlled trial (AVERT).  Stroke im Druck
• 13 Diserens K , Michel P , Bogousslavsky J . Early mobilisation after stroke: Review of the literature.  Cerebrovascular Diseases. 2006;  22 183-190
• 14 Donnan G , Davis S . Neuroimaging the ischaemic penumbra and selection of patients for acute stroke therapy.  Lancet Neurology. 2002;  1 417-425
• 15 Feigin V L, Lawes C M M, Bennett D A et al.. Stroke epidemiology: A review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century.  Lancet Neurology. 2003;  2 43-53
• 16 Hafer-Macko C E, Ryan A S, Ivey F M et al.. Skeletal muscle changes after hemiparetic stroke and potential beneficial effects of exercise intervention strategies.  Journal of Rehabilitation Research and Development. 2008;  45 261-272
• 17 Howells D W, Porritt M J, Rewell S S J et al.. Different strokes for different folks: The rich diversity of animal models of focal cerebral ischemia.  Journal of Cerebral Blood Flow & Metabolism. 2010;  30 1412-1431
• 18 Humm J L, Kozlowski D A, James D C et al.. Use-dependent exacerbation of brain damage occurs during an early post-lesion vulnerable period.  Brain Research. 1998;  783 286-292
• 19 Indredavik B , Bakke F , Slordahl S  et al.. Benefits of a stroke unit: A randomized controlled trial.  Stroke. 1991;  22 1026-1031
• 20 Indredavik B , Bakke R P T, Slordahl S A et al.. Treatment in a combined acute and rehabilitation stroke unit: Which aspects are most important?.  Stroke. 1999;  30 917-923
• 21 Indredavik B , Loege A , Rohweder G  et al.. Early mobilisation of acute stroke patients is tolerated well, increases mean blood pressure, and oxygen saturation and improved consciousness.  Cerebrovascular Diseases. 2007;  23 65
• 22 Janssen H , Bernhardt J , Collier J M et al.. An enriched environment improves sensorimotor function post ischemic stroke.  Neurorehabil Neural Repair. 2010;  24 666-673
• 23 Koslowski D A, James D C, Schallert T  et al.. Use-dependent exaggeration of neuronal injury after unilateral sensorimotor cortex lesions.  Journal of Neuroscience. 1996;  16 4776-4786
• 24 Langhorne P , Stott D , Knight A  et al.. Very early rehabilitation or intensive telemetry after stroke: A pilot randomised trial.  Cerebrovascular Diseases. 2010;  29 352-360
• 25 Lee H , Shin M , Kim Y  et al.. Early treadmill exercise decreases intrastriatal hemorrhage-induced neuronal cell death and increases cell proliferation in the dentate gyrus of streptozotocin-induced hyperglycemic rats.  Journal of Diabetes and Its Complications. 2005;  19 339-346
• 26 Markus H , Ginsberg M . Cerebral perfusion and stroke.  J Neurol Neurosurg Psychiatry. 2004;  75 353-361
• 27 Morris P , Goad M , Thomposon C  et al.. Early intensive care unit mobility therapy in the treatment of acute respiratory failure.  Crit Care Med. 2008;  36 2238-2243
• 28 National Stroke Foundation .Clinical guidelines for acute stroke management. 2007 http://www.strokefoundation.com.au/clinical-guidelines
• 29 Nithianantharajah J , Hannan A J. The neurobiology of brain and cognitive reserve: Mental and physical activity as modulators of brain disorders.  Progress in Neurobiology. 2009;  89 369-382
• 30 Risedal A , Zeng J , Johansson B B. Early training may exacerbate brain damage after focal brain ischaemia in the rat.  Journal of Cerebral Blood Flow and Metabolism. 1999;  19 997-1003
• 31 Ronning O , Guldvog B . Outcome of subacute stroke rehabilitation: A randomized controlled trial.  Stroke. 1998;  29 779-784
• 32 Schweickert W D, Pohlman M C, Pohlman A S et al.. Early physical and occupational therapy in mechanically ventilated, critically ill patients: A randomised controlled trial.  Lancet. 2009;  373 1874-1882
• 33 Skarin M , Bernhardt J , Sjoholm A  et al.. Better wear out sheets than shoes: A survey of stroke professionals‘ early mobilisation practices and concerns.  International Journal of Stroke. im Druck
• 34 Sorbello D , Dewey H M, Churilov L  et al.. Very early mobilisation and complications in the first 3 months after stroke: Further results from phase II of A Very Early Rehabilitation Trial (AVERT).  Cerebrovascular Diseases. 2009;  28 378-383
• 35 Strawbridge W V, Deleger S , Roberts R E et al.. Physical activity reduces the risk of subsequent depression for older adults.  Am J Epidemiology. 2002;  156 328-334
• 36   . Stroke Unit Trialists Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke.  BMJ. 1997;  314 1151-1159
• 37 Stroke Unit Trialists Collaboration . Organised inpatient (stroke unit) care for stroke (review).  Cochrane Database of Systematic Reviews. 2007; 
• 38 Tay-Teo K , Moodie M , Bernhardt J  et al.. Economic evaluation alongside a phase II, multi-centre, randomised controlled trial of very early rehabilitation after stroke (AVERT).  Cerebrovascular Diseases. 2008;  26 475-481
• 39 Tyedin K , Cumming T , Bernhardt J . Quality of life: An important outcome measure in a trial of very early mobilisation after stroke.  Disability and Rehabilitation. 2010;  32 875-884
• 40 Wojner-Alexander A M, Garami Z , Chernyshev O Y et al.. Heads down: Flat positioning improves blood flow velocity in acute ischemic stroke.  Neurology. 2005;  64 1254-1357
• 41 Yang Y , Wang R , Wang P . Early and late treadmill training after focal brain ischemia in rats.  Neuroscience Letters. 2003;  339 91-94