We read with interest the recent article in CHEST (September 2013) by Stiller,1 who provided a systematic review of the literature on physiotherapy in the ICU. The author concluded that early patient mobilization should be a priority in adult ICUs. We agree with this practice and suggest that it is beneficial for most critically ill patients, even in patients not receiving mechanical ventilation. Although not a primary focus of this review, we found little mention of patients in the neuro-ICU, with the exception of intracranial pressure monitoring in neurosurgery patients as seen in Table 3 of the article.1 Between June 2011 and July 2012, we performed mobilization in 30 patients in the ICU within 13 to 24 h of receiving IV recombinant tissue plasminogen activator for acute ischemic stroke at the Mayo Clinic in Florida.2 We tracked the safety of early physiotherapy and found that 67% of the patients had no complications related to mobilization. Moreover, 87% of mobilization activities (ie, sitting, standing, walking, transferring to chair) were tolerated, with no adverse response. Safety was measured by neurologic and hemodynamic monitoring. No patient experienced sustained neurologic deficit or bleeding from any invasive line (eg, venous line, arterial line, or Foley catheter).