Patients with first or recurrent stroke diagnosis, hemorrhage or infarct, within 24 hours of onset of symptoms admitted directly to stroke unit from emergency room. Consciousness: Must at least react to verbal commands.
Pre-stroke (retrospective) modified Rankin Score of 3, 4 or 5 (indicating significant previous disability). Deterioration in patient’s condition in the first hour of admission resulting in direct admission to ICU, a documented clinical decision for palliative treatment (e.g. those with devastating stroke) or immediate surgery. Concurrent diagnosis of rapidly deteriorating disease (e.g. terminal cancer). Unstable coronary or other medical condition that is judged by the investigator to impose a hazard to the patient by involvement in the trial. A suspected or confirmed lower limb fracture at the time of stroke preventing the implementation of the mobilization protocol.Patients who have received rt-PA can be recruited if the attending physician permits and if mobilization within 24 hours of stroke is permitted. Patients cannot be concurrently recruited to drug or other intervention trials. Patients may participate in AVERT if they are also recruited to non intervention trials. Systolic blood pressure less than 110, or greater than 220mmHg. Oxygen saturation of less than 92% with supplementation. Resting heart rate of less than 40 or greater than 110 beats per minute. Temperature of greater than 38.5 C.