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AVERT Trial – Early Mobilisation — SCE Neurology MCQ

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ModerateNeurorehabilitationAVERT Trial – Early MobilisationSCE Neurology

A 65-year-old man with ischaemic stroke is participating in early mobilisation rehabilitation. The AVERT trial results have influenced practice. What did AVERT show about very early mobilisation after stroke?

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Correct answer: C — The AVERT trial showed that very early (within 24 hours) and high-dose mobilisation was associated with worse functional outcomes at 3 months compared with usual care — current guidance recommends early but less intensive mobilisation

The AVERT (A Very Early Rehabilitation Trial, 2015) randomised trial found that very early (within 24 hours) and high-dose mobilisation after acute stroke was associated with WORSE odds of favourable outcome at 3 months compared with usual care. This has led to a more nuanced approach: early mobilisation (within 24–48 hours) is still recommended but should be low-dose initially, gradually increasing as tolerated. The emphasis has shifted from 'get up as early as possible' to 'get up early but gently.' A: Very early high-dose was harmful. C: Prolonged bed rest is also harmful. D: Mobilisation starts during inpatient stay. E: The trial had clear results.

Reference: AVERT Trial (2015); RCP Stroke Guidelines; NICE CG162