Comparison of very early mobilization (less than 24h), early mobilization 24-48h), and standard mobilization (more than 48h) in improving the functional outcomes in acute stroke: a systematic review

Mohammad N Almotiri; Mohammed Yousef Almohaimeed; Mohammed N Aljabr; Juwan Mohammed Almutairi; Shefa Owaiyedh Almutairi; Ahmad Khalaf Alanazi; Emad Abdulaziz Yousef Alhoody; Ghazi Ibrahim A Alromayan; Oabdh Abdulaziz Ibrahim Almushiqh

doi:10.24911/IJMDC.51-1777807632

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Online Published: 03 Aug 2026

IJMDC. 2026; 10(8): 2416-2428

doi: 10.24911/IJMDC.51-1777807632

Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review

Mohammad N. Almotiri, Mohammed Yousef Almohaimeed, Mohammed N. Aljabr, Juwan Mohammed Almutairi, Shefa Owaiyedh Almutairi, Ahmad Khalaf Alanazi, Emad Abdulaziz Yousef Alhoody, Ghazi Ibrahim A. Alromayan, Oabdh Abdulaziz Ibrahim Almushiqh.

Abstract
Strokes continue to be one of the main causes of chronic disability and mortality globally. However, the optimal mobilization time after stroke onset remains contested. This systematic review and meta-analysis aimed to compare the effectiveness and safety of very early (<24 hours), early (24-48 hours), and delayed/standard (>48 hours) mobilization protocols in terms of achieving good functional outcomes, motor improvement, reducing length of hospital stay, and safety in acute stroke patients. A systematic literature search was conducted in major databases for relevant literature published up to 2025. A total of 21 studies were analyzed. Very early mobilization (VEM) (<24 hours) had minimal or slightly reduced chances of a favorable modified Rankin Scale outcome in large trials. There was no increase in mortality rate or severe adverse events in any treatment group. Improvements in quality of life were inconsistent. Early (24-48 hours) mobilization was the optimal mobilization strategy in terms of functional outcomes and length of hospital stay. There was no extra benefit from VEM in terms of functional independence despite their safety.

Key words: Stroke, early mobilization, very early mobilization, functional outcomes, systematic review

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Pubmed Style

Almotiri MN, Almohaimeed MY, Aljabr MN, Almutairi JM, Almutairi SO, Alanazi AK, Alhoody EAY, Alromayan GIA, Almushiqh OAI. Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. IJMDC. 2026; 10(8): 2416-2428. doi:10.24911/IJMDC.51-1777807632

Web Style

Almotiri MN, Almohaimeed MY, Aljabr MN, Almutairi JM, Almutairi SO, Alanazi AK, Alhoody EAY, Alromayan GIA, Almushiqh OAI. Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. https://www.ijmdc.com/?mno=319541 [Access: August 25, 2026]. doi:10.24911/IJMDC.51-1777807632

AMA (American Medical Association) Style

Almotiri MN, Almohaimeed MY, Aljabr MN, Almutairi JM, Almutairi SO, Alanazi AK, Alhoody EAY, Alromayan GIA, Almushiqh OAI. Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. IJMDC. 2026; 10(8): 2416-2428. doi:10.24911/IJMDC.51-1777807632

Vancouver/ICMJE Style

Almotiri MN, Almohaimeed MY, Aljabr MN, Almutairi JM, Almutairi SO, Alanazi AK, Alhoody EAY, Alromayan GIA, Almushiqh OAI. Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. IJMDC. (2026), [cited August 25, 2026]; 10(8): 2416-2428. doi:10.24911/IJMDC.51-1777807632

Harvard Style

Almotiri, M. N., Almohaimeed, . M. Y., Aljabr, . M. N., Almutairi, . J. M., Almutairi, . S. O., Alanazi, . A. K., Alhoody, . E. A. Y., Alromayan, . G. I. A. & Almushiqh, . O. A. I. (2026) Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. IJMDC, 10 (8), 2416-2428. doi:10.24911/IJMDC.51-1777807632

Turabian Style

Almotiri, Mohammad N., Mohammed Yousef Almohaimeed, Mohammed N. Aljabr, Juwan Mohammed Almutairi, Shefa Owaiyedh Almutairi, Ahmad Khalaf Alanazi, Emad Abdulaziz Yousef Alhoody, Ghazi Ibrahim A. Alromayan, and Oabdh Abdulaziz Ibrahim Almushiqh. 2026. Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. International Journal of Medicine in Developing Countries, 10 (8), 2416-2428. doi:10.24911/IJMDC.51-1777807632

Chicago Style

Almotiri, Mohammad N., Mohammed Yousef Almohaimeed, Mohammed N. Aljabr, Juwan Mohammed Almutairi, Shefa Owaiyedh Almutairi, Ahmad Khalaf Alanazi, Emad Abdulaziz Yousef Alhoody, Ghazi Ibrahim A. Alromayan, and Oabdh Abdulaziz Ibrahim Almushiqh. "Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review." International Journal of Medicine in Developing Countries 10 (2026), 2416-2428. doi:10.24911/IJMDC.51-1777807632

MLA (The Modern Language Association) Style

Almotiri, Mohammad N., Mohammed Yousef Almohaimeed, Mohammed N. Aljabr, Juwan Mohammed Almutairi, Shefa Owaiyedh Almutairi, Ahmad Khalaf Alanazi, Emad Abdulaziz Yousef Alhoody, Ghazi Ibrahim A. Alromayan, and Oabdh Abdulaziz Ibrahim Almushiqh. "Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review." International Journal of Medicine in Developing Countries 10.8 (2026), 2416-2428. Print. doi:10.24911/IJMDC.51-1777807632

APA (American Psychological Association) Style

Almotiri, M. N., Almohaimeed, . M. Y., Aljabr, . M. N., Almutairi, . J. M., Almutairi, . S. O., Alanazi, . A. K., Alhoody, . E. A. Y., Alromayan, . G. I. A. & Almushiqh, . O. A. I. (2026) Comparison of very early mobilization (less than 24 hours), early mobilization (24-48 hours), and standard mobilization (more than 48 hours) in improving the functional outcomes in acute stroke: a systematic review. International Journal of Medicine in Developing Countries, 10 (8), 2416-2428. doi:10.24911/IJMDC.51-1777807632

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