PURPOSE: Early mobilization is believed to be helpful for patients with acute ischemic stroke. This study aimed to compare the difference between starting rehabilitation between 24 and 48 h and 72 and 96 h following the onset of ischemic stroke. MATERIALS AND METHODS: This was a single-center, single-blind, randomized controlled trial. The early rehabilitation (ER) group started exercising between 24 and 48 h after stroke onset, which the standard rehabilitation (SR) group started exercising between 72 and 96 h. The two groups received sitting, standing, and repetitive body strength training respectively. RESULTS: In this study, 110 patients were analyzed. Patients in the early rehabilitation group had more favorable outcomes (the modified Rankin Scale score 0 to 2, ER group 32 versus SR group 20, adjusted odds ratio 2.27, 95% CI 1.05 to 4.87; p = 0.036) at 3-month follow-up. The simplified Fugl-Meyer assessment (FMA) scores for the lower extremity were influenced by the interaction effect (F = 7.24, p = 0.01). The post-hoc analysis revealed a difference in the lower extremity FMA score at one week after stroke (difference 2.30 (95% CI 0.65 to 3.96); p = 0.007). CONCLUSIONS: Early physical rehabilitation training between 24 and 48 h may be beneficial and improve patients' lower extremity function within the first week. CLINICAL TRIAL REGISTRATION UNIQUE IDENTIFIER: NCT02718534.

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