While previous studies have primarily focused on cortical strokes, this study also stratified outcomes by stroke type, investigating the effects of EA in both cortical and subcortical stroke cohorts.
A total of 100 acute stroke patients were allocated to receive either F-EA-PT, consisting of twice-daily sessions for 3 out of the first 5 days of hospitalization followed by daily treatment sessions, or SOC-PT, consisting of once-daily sessions 3-5 days per week. EA training emphasizes impairments throughout mobility to challenge the individual, enhancing implicit error learning. Functional outcomes were assessed using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Activity Measure for Post-Acute Care (AM-PAC), and Postural Assessment Scale for Stroke (PASS). A repeated measures mixed model was used to compare treatment groups, with stratified analysis by stroke type.
The F-EA-PT group demonstrated significantly greater reductions on NIHSS (-1.34, P = .0426) and mRS (-0.81, P = .0037) from admission to 90-day follow-up compared to the SOC-PT group. The F-EA-PT group also showed larger magnitudes of change in AM-PAC at treatment day 3 (2.12, P = .0009) and discharge (2.75, P .0001). Notably, PASS score improvements in the subcortical stroke cohort were comparable to those in the cortical stroke cohort (9.4 vs. 12.1 points, respectively), both significantly greater than their control group counterparts.
Increased frequency and error augmentation in physical therapy significantly improve functional outcomes post-stroke, as evidenced by NIHSS, mRS, AM-PAC, and PASS scores. The intervention was safe, with only one adverse event reported.
This regimen, traditionally associated with cortical strokes, also shows promise in subcortical strokes, suggesting a broader applicability of EA in acute stroke rehabilitation.
Stroke Rehabilitation
Acute Care
