Wang X, Moullaali TJ, Ouyang M, et al. - Since patients with premorbid functional impairment are usually excluded from acute stroke trials, researchers sought to evaluate the effect of including such patients in the Head Positioning in acute Stroke Trial (HeadPoST) and early additional impairment on outcomes. There were 1,984 (23.9%) with premorbid functional impairment (mRS 2–5) out of 8,285 patients (38.9% female, mean age 68 ± 13 years) with complete data. According to findings, an early poststroke functional impairment that surpassed premorbid levels was linked to worse 90-day outcome; this correlation increased with greater premorbid functional impairment. However, the resulting treatment effect was not materially impacted by the inclusion of premorbid impaired patients in the HeadPoST. Patients with greater premorbid functional impairment were less likely to develop additional impairment.