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BMJ

BMJ neurology open

Early out-of-bed mobilisation within 48 hours after acute stroke and in-hospital complications: a retrospective cohort study

16 October 2026Original research1 min read

By Temraz Y, Moftah E, Aljasir M and 3 others.

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Abstract
Keywords
Authors
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Abstract

Background

Early mobilisation is widely promoted in acute stroke care, but observational evaluations can be biased because sicker patients often mobilise later.

Objective

To evaluate the association between early out-of-bed mobilisation (≤48 hours) and in-hospital complications and to describe discharge outcomes.

Methods

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We conducted a retrospective cohort study using routinely collected clinical data from a single centre (admissions from May 2024 to May 2025). Patients were included in the primary analysis if time to first mobilisation was recorded. The exposure was mobilisation within 48 hours versus after 48 hours. The primary outcome was any in-hospital complication. Secondary outcomes were favourable discharge modified Rankin Scale (0-2), discharge to home and length of stay. Confounding by indication was addressed using propensity score overlap weighting based on pre-exposure covariates. Relative risks (RR) were estimated using overlap-weighted modified Poisson regression with robust SEs. Risk differences (RD) used bootstrap resampling (500 replicates). A landmark analysis restricted to length of stay ≥2 days was used to reduce immortal-time bias.

Results

The dataset included 400 admissions; mobilisation timing was recorded for 371 patients (mean age 70.1 years, SD 11.5; 46.6% female; 82.7% ischaemic stroke; median National Institutes of Health Stroke Scale 10 (IQR 6-14)). Among recorded cases, 245 (66.0%) were mobilised within 48 hours. In overlap-weighted analyses, early mobilisation was associated with lower complication risk (RR 0.689, 95% CI 0.498 to 0.953; p=0.024), with RD -0.123 (bootstrap 95% CI -0.233 to -0.005). In the landmark cohort, the association remained similar (RR 0.709, 95% CI 0.513 to 0.979; p=0.036). Discharge outcomes were directionally favourable but less precise after weighting.

Conclusions

In routine acute stroke care, early out-of-bed mobilisation within 48 hours was associated with fewer in-hospital complications and remained robust in a landmark sensitivity analysis. Longer-term functional outcomes should be evaluated in studies with post-discharge follow-up.

Keywords

REHABILITATION
STROKE

Authors

Temraz Y
Moftah E
Aljasir M
Behairi NA
Almutairi A
Batarfi M

Source

Published in BMJ neurology open. The abstract is shown as published and remains the work of its authors; read the full article at the source.

pubmed.ncbi.nlm.nih.gov/42921127/

Prognia lists this article for reference and education. It is not medical advice. Always read the original and follow current guidelines and local protocols before acting on it.

At a glance

Journal: BMJ neurology open
Type: Original research
Published: 16 October 2026
Specialty: Neurology
Read time: 1 min
Authors: 6
DOI: 10.1136/bmjno-2026-001587
PubMed: 42921127

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