Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

Protocol of early physiotherapeutic intervention in patients with acute stroke intra-hospital: systematic review

Fonseca Junior, Paulo Roberto; Vale, Vanessa Donato do


Background: Stroke is associated with high rates of mortality and disability. Physiotherapy plays a key role in the treatment these patients. Early rehabilitation proves to be an important point in the recovery process, as it helps to reduce complications and loss of functional capacity. Objective: This systematic review aims to analyze the effects of early physiotherapy protocols on recovery after acute stroke intra-hospital. Methods: The research sought references with publication date between January 2010 and March 2017, through a database such as MedLine (by PubMed), Lilacs, Cochrane Library, Scielo and PEDro. Results: A total of 30 articles were identified. After reading their titles, abstracts and full texts, and being evaluated, punctuated and qualified by the PEDro and Jadad scale, only 6 articles were selected for this review. Conclusion: This study provides an insight into the variety of approaches adopted by therapists that can be used in this type of population, demonstrating improvement in several motor and functional aspects, and confirming that the intervention performed at an early stage is safe and without contra- indications.


Stroke, Physical Therapy Modalities, Hospital.


1. Almeida SRM. Análise epidemiológica do Acidente Vascular Cerebral no Brasil. Rev Neurocienc. 2012;20(4):481-2.

2. Teixeira I. O envelhecimento cortical e a reorganização neural após o acidente vascular encefálico (AVE): implicações para a reabilitação. Cienc Saúde Col. 2008;13(supl.2):2171-8.

3. Vecchia RD, Ruiz T, Bocchi SCM, Corrente JE. Qualidade de vida na terceira idade: um conceito subjetivo. Rev Bras Epidemiol. 2005; 8(3):246-52.

4. Borges D, Moura EW. Lima E, Silva PAC. Fisioterapia aspectos clínicos e práticos da reabilitação. São Paulo: Artes Medicas, 2007.

5. Duncan PW, Sullivan KJ, Behrman AL, Azen SP, Wu SS, Nadeau SE, et al. Body-weight-supported treadmill rehabilitation after stroke. N Engl J Med. 2011.

6. Benvegnu AB, Gomes LA, Souza CT, Cuadros TBB, Pavão LW, Ávila SN. Avaliação da medida de independência funcional de indivíduos com sequelas de acidente vascular encefálico (AVE). Revista Ciência & Saúde. 2008;1(2):71-7.

7. Valente SCF, Paula EB, Abranches M, Costa V, Borges H, Chamlian TR, et al. Resultados da fisioterapia hospitalar na função do membro superior comprometido após acidente vascular encefálico. Rev Neurocienc. 2006;14(3):122-6.

8. Mas MA, Inzitari M. A critical review of Early Supported Discharge for stroke patients: from evidence to implementation into practice. Int J Stroke 2015; 10(1): 7–12

9. Duncan PW, Zorowitz R, Bates B, Choi JY, Glasber JJ, Graham GD, et al. Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke. 2005;36:100–43.

10. Rothwell PM, Algra A, Amarenco P. Medical treatment in acute and long term secondary prevention after transient ischaemic attack and ischaemic stroke. Lancet. 2011;377:1681–92.

11. Venturelli PM; Robinson T; Lavados PM; Olavarría VV; Arima H; Billot L, et al. Regional variation in acute stroke care organisation. Journal of the Neurological Sciences. 371;(2016):126-130.

12. Liberati A., Altman DG., Tetzlaff J., Mulrow C., Gøtzsche PC., Ioannidis JP. Et al. The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.

13. Shiwa SR, Costa LOP, Moser ADL, Aguiar IC, Oliveira LVF. Pedro: the physiopherapy evidence database. Fisioterapia em Movimento. 2011;24(3): 523-33.

14. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1-12.

15. Boss HM, Van Schaik SM, Deijle IA, de Melker EC, van den Berg BT, Scherder EJ, Bosboom WM, et al. Safety and feasibility of post-stroke care and exercise after minor ischemic stroke or transient ischemic attack: MotiveS & MoveIT. NeuroRehabilitation. 2014;34:401–7.

16. Chen JC, Lin CH, Wei YC, Hsiao J, Liang CC. Facilitation of motor and balance recovery by thermal intervention for the paretic lower limb of acute stroke: a single-blind randomized clinical trial. Clin Rehabil. 2011;25:823–32.

17. Malhotra S, Rosewilliam S, Hermens H, Roffe C, Jones P, Pandyan AD. A randomized controlled trial of surface neuromuscular electrical stimulation applied early after acute stroke: effects on wrist pain, spasticity and contractures. Clin Rehabil. 2013;27:578-90.

18. Morris JH, Van Wijck F. Responses of the less affected arm to bilateral upper limb task training in early rehabilitation after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2012;93:1129-37.

19. Skvortsova VI, Ivanova GE, Rumyantseva NA, Staritsyn AN, Kovrazhkina EA, Suvorov AY. Current approaches to restoring walking in patients during the acute phase of cerebral stroke. Neuroscience and Behavioral Physiology 2011;41(5):536-42.

20. Tyson S, Wilkinson J, Thomas N, Selles R, McCabe C, Tyrrell P, et al. Phase II pragmatic randomized controlled trial of patient-led therapies (mirror therapy and lower-limb exercises) during inpatient stroke rehabilitation. Neurorehabil Neural Repair. 2015;29(9):818-26.

21. Malavolta EA, Demange MK, Gobbi RG,. Randomized controlled clinical trials in orthopedics. Rev Bras Ortop. 2011;46(4):452–9.

22. Australian Commission on Safety and Quality in Health Care. Acute stroke clinical care standard. Sydney: ACSQHC, 2015. This document was current at the time of printing. For the latest version of this document, please visit

23. Winstein CJ; Stein J; Arena R; Bates B; Cherney LR; Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke. 2016;47(6): 98-169.

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