Early Bobath-based neurorehabilitation after mechanical thrombectomy for moderate-to-severe hemiparesis: preliminary findings from a propensity score-matched cohort study.

AIM: This study aimed to evaluate whether early Bobath-based neurorehabilitation improves motor and functional recovery in patients with acute ischemic stroke and moderate-to-severe hemiparesis after anterior-circulation mechanical thrombectomy.

METHODS

We conducted a single-center retrospective propensity score-matched cohort study comparing early Bobath-based neurorehabilitation with conventional rehabilitation in AIS patients with moderate-to-severe hemiparesis after anterior-circulation mechanical thrombectomy. Patients aged ≥18 years initiated rehabilitation within 30 days after the procedure, and complete discharge and follow-up data were required for inclusion in the matched cohort. The primary outcome was change in Fugl-Meyer Assessment (FMA) motor score from baseline to discharge. Secondary outcomes included Modified Barthel Index (MBI), Modified Ashworth Scale (MAS), modified Rankin Scale (mRS), quality of life, and safety outcomes during 12-month follow-up.

RESULTS

After matching, 206 patients (103 per group) were included. At discharge, the Bobath group showed greater improvement in motor function and daily living ability than the conventional group (adjusted mean difference: FMA 5.7 points, 95% CI 3.4-8.0; MBI 6.6 points, 95% CI 4.0-9.3; both p < 0.001). Improvements remained significant at 3 months but not at 12 months. Functional independence (mRS ≤2) at 3 months was more frequent in the Bobath group (82.5% vs 73.8%; p = 0.05). Complication rates were similar between groups.

CONCLUSIONS

Early Bobath-based neurorehabilitation is associated with better short-term motor and functional recovery without increased adverse events after mechanical thrombectomy. The between-group differences attenuated by 12 months; therefore, further multicenter prospective studies are needed to confirm durability and long-term benefit.