Early mobilization in patients with aneurysmal subarachnoid hemorrhage: a prospective observational study.

One hospital, one country, 102 patients. Timing, staffing and barriers here may look nothing like yours. There was no control group and no randomisation, so the study can only describe what happened. It cannot show whether mobilising patients early helped, harmed or changed anything. The patients admitted with a poor clinical status were much sicker to begin with, so the large gap in walking between the two groups mostly reflects how severe the bleed was, not what therapy they received. The number of sessions was counted, but how long each lasted and how intense it was were not recorded, so the total dose of therapy is unknown. Only sessions delivered by physical therapists were counted, so mobilisation by nursing staff or activity outside therapy time is missing. Day-14 mobility scores were missing for 9 patients, including those who died before day 14, and these were not estimated. Patients had to be walking independently before their bleed and free of prior cognitive or neurological problems, so nothing here applies to the more dependent patients on a general neuro ward.

The text provided contains no funding statement and no conflict of interest declaration, so it is not possible to say who paid for the work or what interests the authors declared.

Do not read this as proof that early mobilisation is safe or that it helps patients recover. There was no comparison group. Everyone in the study was managed the same way, so the 8.3% of sessions that stopped early and the half of patients walking by two weeks cannot be credited or blamed on mobilisation. It is a description of usual practice, and the gap between patients admitted well and patients admitted unwell mostly reflects how severe their bleed was.