Early versus Late Physical Therapy in Functional Recovery After Stroke: A Systematic Review with Meta-Analysis
DOI:
https://doi.org/10.62827/fb.v27i7.1263Keywords:
Stroke; Physical Therapy; Neurological Rehabilitation; Functional Status; Meta-Analysis.Abstract
Introduction: Stroke is one of the leading causes of death and disability worldwide, causing motor, sensory, functional, and cognitive impairments that compromise patients’ independence. Physical therapy is essential for rehabilitation, especially in the first few days—a period of peak neuroplasticity—but there is still debate regarding the optimal time to begin treatment. Objective: To discuss the effectiveness of early and late physical therapy in the recovery of patients after a stroke. Methods: A systematic search with meta-analysis was conducted in the following databases: PubMed/MEDLINE (Medical Literature Analysis and Retrieval System Online), Cochrane CENTRAL (Cochrane Central Register of Controlled Trials), Scopus, LILACS (Latin American and Caribbean Health Sciences Literature), SciELO (Scientific Electronic Library Online), and PEDro (Physiotherapy Evidence Database). Studies involving adults aged 18 years or older with a diagnosis of stroke were included. Eligible studies had to evaluate early physical therapy initiated within 72 hours after stroke onset. Methodological quality was assessed using the Risk of Bias (RoB 2) tool, and data were synthesized using a random-effects model. Results: Four articles were included. Early physical therapy demonstrated a benefit in motor recovery at three months (SMD = 1.23; 95% CI: 0.21–2.25; p = 0.018) and in functional independence (MD = 9.09 points; 95% CI: 3.78–14.40; p < 0.001), as well as motor improvement in the lower limbs during the first week (MD = 2.30; p = 0.007) and greater functional independence at 90 days (OR = 2.27; 95% CI: 1.05–4.87; p = 0.036). Patients who received early intervention were able to return to work sooner and reported a better quality of life in the long term. Conclusion: Physical therapy initiated within the first 72 hours is more effective than delayed intervention, promoting superior motor and functional recovery.
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Copyright (c) 2026 Ellen Cristina Rodrigues Neves, Letícia Machado Rodrigues Penna , Rafaela de Carvalho Costa Damasceno, Thamires Aparecida Fernandes Colares, Daniel Martins Rossi Lima (Autor)
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