CHAMGAP
APPROVEDReviewed and approved by the Chamgap Editorial Team (2026-08-14). The draft was written by AI, the existence of all 1 cited sources was verified at the original page, and the verdict passed blind grading and adversarial audit. Methodology v0.7.
Verdict No. 2559 · Search date 2026-08-14 · Methodology v0.7

Frequent higher-dose mobilisation within 24 hours after stroke,
does it really help with Increase in favorable three-month functional outcome, modified Rankin Scale 0 to 2?

30-Second Summary
D
Evidence Grade D · 34 · Safety warning
Frequent higher-dose mobilisation within 24 hours reduced favorable three-month recovery in AVERT.
AVERT significantly worsened the primary functional outcome, so timing, frequency, and total mobilisation dose should be individualized by the acute stroke rehabilitation team.
What the
research shows
The grade is D. AVERT randomized 2,104 patients and analyzed 2,083 at three months. Favorable outcome occurred in 480/1,038 (46.2%) versus 525/1,045 (50.2%), adjusted OR 0.73 (95% CI 0.59 to 0.90), P=0.004, significantly worse with the intervention. A large independent trial contradicted the benefit claim, but this was not repeated refutation of the same regimen, so the result is D, not F, with 34 points.
What the
ads claim
Marketing cannot isolate only 'moving early.' AVERT tested a package combining start within 24 hours with greater session frequency and total dose than usual care.
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Useful facts when choosing a product

  • Ninety-two percent of intervention patients and 59% of usual-care patients first mobilized within 24 hours.
  • Randomization assigned 1,054 versus 1,050 patients.
  • The favorable-outcome analysis included 1,038 versus 1,045.
Gap Measurement · Verdict 2559 · D 34
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Across 56 units in five countries, baseline data were entered before centralized web-based computer block randomization. Patients, three-month outcome assessors, and data-management investigators were masked, and 2,083/2,104 (99%) were analyzed by allocation. The registered and published three-month mRS 0 to 2 primary endpoint matched. Funding came from NHMRC, Singapore Health, stroke charities in the UK, Scotland and Northern Ireland, and NIHR.

02

Why this is classified as D (34)

One rigorous independent trial significantly worsened a patient-centered functional endpoint, but there was no independent repeated trial of the same regimen, giving D with 34 points.

Counterpoint. D does not mean all rehabilitation is harmful; it is specific to AVERT's frequent, higher-dose protocol within 24 hours.

Rejudgment record. Cross-check applied — We cross-checked the AVERT paper, registry, and public report for centralized randomization, masked assessment, ITT denominators, the prespecified mRS endpoint, events, and public funding.

Scoring profile behind this grade
EndpointPPatient-reported treatment goal - the symptom is the goal
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE-Harm increased in the trials
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Increased favorable functional recovery at three monthsDAdjusted OR was 0.73, significantly in the opposite direction.

Cross-check — Codex and Claude

This verdict was drafted by Codex through literature review and source-existence checks, cross-checked through blind grading and adversarial audit, and settled by reapplying the methodology boundary rules. Cases with split grades were resolved through rejudgment.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
AVERT Trial Collaboration group, 2015 AVERTAssessor-masked multinational randomized trial at 56 stroke units1,045NHMRC, Singapore Health, NIHR, and UK stroke charitiesFavorable three-month functional outcome, mRS 0 to 2480/1,038 (46.2%) versus 525/1,045 (50.2%), adjusted OR 0.73 (95% CI 0.59 to 0.90), P=0.004Pivotal independent large functional-outcome RCT
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Receipt — 1 References

All 1 cited sources were verified for existence at the original page (as of 2026-08-14).

AVERT Trial Collaboration group. Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial. Lancet. 2015;386:46-55. PMID: 25892679. DOI: 10.1016/S0140-6736(15)60690-0.
checked
Draft and rewrite: Codex (AI) · Verification: Codex blind grading and adversarial audit · Final adjudication: Claude
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none

Cite this verdict

Frequent higher-dose mobilisation within 24 hours after stroke x better functional recovery Evidence Grade D card
[Chamgap] Frequent higher-dose mobilisation within 24 hours after stroke x better functional recovery — Evidence Grade D·34. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/cognition/very-early-high-dose-mobilisation-stroke-functional-outcome/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.