Analyzes of the ICF Domain of Activity After a Neurological Early Mobility Protocol in a Public Hospital in Brazil.
Fernanda Dos Santos Lima, Vinícius da Silva Carvalho, Inaiacy Souto Bittencourt and 1 others
PMID 36188978WHAT IT FOUND
Neurological inpatients improved their mobility and daily activity independence after a progressive early mobility protocol, even when started days after admission.
Patients with moderate initial ability showed the largest gains, while those already walking independently saw little change.
Key findings
01Patients improved their hospital mobility independence scores from a median of 1 to 4 out of 12 after the protocol.
02Daily living independence scores improved from a median of 36 to 52 out of 100, moving the group from severe to moderate dependency.
03Patients starting with moderate mobility showed the most significant improvements in sitting, standing, and walking activities.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study had no control group, so it is impossible to know how much of the improvement was due to the protocol versus natural recovery. Mobility treatment started on average 10 days after admission, much later than the 24 to 72 hour window recommended for early mobility. The study took place in a single public hospital in Brazil, which may limit how well the results apply to other settings. The International Classification of Functioning qualifiers were derived by translating existing scores rather than being assessed directly by clinicians.
Declared interests
The authors declared no conflicts of interest. The work was funded by the Higher Education Personnel Improvement Coordination in Brazil.
The easy way to misread this
Do not assume this protocol is safe or effective for patients started within the first 24 to 72 hours of admission. The patients in this study waited an average of 10 days to begin treatment, so these results do not apply to very early mobilization.