Efficacy of Early Task-Oriented Rehabilitation in Acute Stroke Recovery

Stroke represents a major health problem worldwide and is associated with long-term disability, particularly motor dysfunction of the upper and lower limbs. Early initiation of rehabilitation is believed to enhance neuroplasticity, maximize recovery, and improve independence in daily living activities. While conventional physiotherapy focuses on stretching, balance training, and strengthening exercises, task-oriented rehabilitation emphasizes practicing functional, goal-directed tasks such as reaching for objects, buttoning shirts, sit-to-stand practice, walking, and stair climbing.

This study is a randomized controlled trial including 148-158 patients with acute ischemic or hemorrhagic stroke admitted to Assiut University Hospitals within 48 hours of onset. Participants will be randomly assigned to either the experimental group (early task-oriented rehabilitation) or the control group (traditional rehabilitation). Sessions will be delivered 3-4 times per week, each lasting 45-60 minutes, both during hospital stay and follow-up in outpatient clinics.

The primary outcome is functional recovery assessed by the Fugl-Meyer Assessment and Functional Independence Measure (FIM) at 3 months. Secondary outcomes include NIH Stroke Scale, Modified Rankin Scale, Stroke Impact Scale, depression scores, and quality of life measures.

This trial is expected to provide high-quality local evidence regarding the benefits of task-oriented rehabilitation in the acute phase of stroke recovery, which may inform clinical practice and guide rehabilitation protocols in Egypt.

Inclusion criteria

• Acute ischemic or hemorrhagic stroke diagnosed clinically and confirmed by imaging.
• Admission to hospital or referral to outpatient clinic within 48 hours after stroke onset.
• Age ≥ 18 years.
• Both sexes.
• Medically stable and fit for rehabilitation.

Exclusion criteria

• Severe stroke not suitable for rehabilitation.
• Severe comorbidities (e.g., vital organ failure, malignancy).
• Severe aphasia, or severe visual or auditory impairment interfering with training.
• Severe upper limb spasticity (Modified Ashworth Scale > 3).
• Cognitive dysfunction (MMSE < 24 for educated; < 17 for illiterate patients).
• Stroke mimics (e.g., seizures, brain tumor, CNS infection, demyelinating diseases, hypoglycemia).
• Pregnancy.