Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke.

This was an observational study, not a randomised trial, so it shows association with therapy timing but cannot prove that starting therapy earlier caused better outcomes. The study was done at one acute care centre in a large metropolitan area, so results may not apply to other hospitals or patient populations. Most outcome measures were patient-reported Neuro-QOL and telephone mRS, not performance tests such as gait speed or arm motor testing. The therapy services were PT, OT, and SLP consults and treatments combined, so the contribution of any one discipline cannot be separated. Of 764 enrolled patients, 553 were analysed, and only 275 patients received an in-hospital treatment, so the treatment timing findings may not apply to patients discharged before treatment. The study did not identify an optimal time point for starting therapy services. The Barthel Index was dropped from routine collection because it correlated strongly with mRS in preliminary data, so self-care disability may not have been measured in all follow-up assessments.

The supplied text does not include a conflicts of interest or funding statement. The journal metadata lists research support from NIH and U.S. government sources.

Do not conclude that earlier therapy will cause better recovery. The study was observational, measured PT, OT, and SLP services together, and did not find an optimal time point. It also did not show that therapy within 24 hours is safe or best, because no patient received therapy within 24 hours.