Title: Vitamin D Supplementation in Acute Ischemic Stroke Rehabilitation: A Potential Game-changer? (P9-5.008)
Authors: Arthur Gribachov, Jamir Pitton Rissardo, Ana Leticia Fornari Caprara, and Vishnu Vardhan Byroju
Conference: 2026 AAN, Chicago, IL
Objective
To assess the effect of Vitamin D (VitD) supplementation versus placebo on neurological and functional recovery in patients with acute ischemic stroke (AIS) undergoing physical therapy (PT).
Background
Vitamin D deficiency is prevalent in AIS and may impair neuroplasticity and rehabilitation outcomes. Supplementation could enhance recovery, but evidence remains inconclusive.
Design/Methods
We systematically searched PubMed for randomized controlled trials comparing VitD supplementation with placebo in AIS patients receiving PT. Outcomes included NIH Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI), modified Barthel Index (mBI), Berg Balance Scale (BBS), and Functional Ambulation Scale (FAS). Mean differences (MD) with 95% confidence intervals (CI) were pooled using fixed- and random-effects models (DerSimonian-Laird).
Results
Five trials (PMIDs: 29950783, 31181657, 32567290, 38011419, 38024000) were included. VitD significantly improved NIHSS at 3 months in the fixed-effect model (MD -1.21; 95% CI -1.801to -0.61; p < 0.01), but not in the random-effects model (MD -0.84; 95% CI -2.53 to 0.84; p = 0.32). Effects on mRS (MD -0.30; 95% CI -0.89 to 0.29) and BI (MD 0.63; 95% CI -3.03 to 4.28) were modest and inconsistent. Functional outcomes favored VitD: mBI (MD 8.85; 95% CI 7.93–9.77), FAS (MD 0.68; 95% CI 0.60–0.76), and BBS (MD 11.01; 95% CI 10.27–11.75). Heterogeneity was high (I² = 64%) due to variable dosing and follow-up.
Conclusions
VitD supplementation during the acute stroke phase, combined with PT, may enhance neurological recovery and improve balance and ambulation. However, evidence is limited by small sample sizes and methodological variability. Larger, standardized trials are needed.
Citation
Gribachov A, Rissardo JP, Caprara AL, Byroju VV. Vitamin D Supplementation in Acute Ischemic Stroke Rehabilitation: A Potential Game-changer?(P9-5.008). Neurology 2026;106(11_suppl_1):944. doi: 10.1212/WNL.0000000000213210.
Figure 1. Forest plot of NIHSS change demonstrating improved neurological outcomes with vitamin D at 3 months in fixed-effect analysis, with heterogeneity limiting consistency across studies.
Figure 2. Forest plot of mean difference in Barthel Index at 3 months comparing vitamin D versus placebo during post-stroke rehabilitation; pooled analysis shows no significant functional independence improvement.