Previous studies have demonstrated that intracerebral hemorrhage (ICH) is more severe, and associated with worse functional outcomes, than ischemic stroke. This Chinese study compared the effects of very early rehabilitation (VER) to that of standard care for patients with ICH.

Patients presenting within 48 hours of first-time ICH were randomized to receive VER plus standard care or standard care alone. In China, standard rehabilitation care involves exercises, stretching, neuromuscular electrical stimulation and functional training, beginning one week after stroke admission.

Participants in the VER group began therapy within 48 hours of ICH onset. During that week, the standard care group received no active rehabilitation, with the main focus being medical management. The primary outcome measure was death, with secondary outcomes including the Short Form-36 Health-Related Quality-of-Life measure, the Modified Barthel Index, functional measure of activities of daily living and scores on the Self Rated Anxiety Scale.

Of the 243 patients studied, patients receiving standard treatment were less likely to be alive at six months after stroke than those in the early intervention group (hazard ratio, 4.25). While no statistically significant differences were found between groups in secondary outcome measures at three months, at six months a significant difference was found between groups on all outcome measures, favoring the intervention group. The average length of hospital stay was 10 days less in the treatment group (P<0.001).

This Chinese study of patients with intracerebral hemorrhage found that early mobilization, within 48 hours, is superior to standard care in reducing deaths and improving outcomes at six months.