PTOTSurveyJournal of rehabilitation medicine2024

Early mobilization of patients with subarachnoid haemorrhage: a national survey of french intensive care units.

Adéla Foudhaili, Damien Vitiello, Benjamin Glenn Chousterman

PMID 38192161

WHAT IT FOUND

Early mobilization for aneurysmal subarachnoid haemorrhage varies widely across French intensive care units.

Ninety percent of units lack a written protocol, and many prohibit out-of-bed movement due to unstandardized safety concerns rather than evidence.

Key findings

01Ninety percent of surveyed intensive care units did not have a written mobilization protocol for patients with aneurysmal subarachnoid haemorrhage.

02Twenty-nine percent of services systematically prohibited out-of-bed mobilization regardless of severity, and sixteen percent prohibited all motor physiotherapy for a predefined period.

03The main factors delaying or interrupting physiotherapy were intracranial hypertension, treated vasospasm, suspicion of vasospasm, and inability to tolerate external ventricular derivation clamping.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study is a survey of professional beliefs and practices, not a clinical trial, so it cannot determine if the reported mobilization restrictions actually improve or harm patient outcomes. Results are limited to French neuro-intensive care units, so practices may differ significantly in other healthcare systems. Responses were based on self-reported clinical experience and beliefs, which may not accurately reflect actual patient care or adherence to unspoken habits. The paper notes that existing observational studies on safety may not provide sufficient evidence to reassure clinicians, contributing to the continuation of conservative practices despite limited data.

Declared interests

The provided text does not contain a specific conflicts of interest or funding declaration.

The easy way to misread this

Do not interpret the high rate of mobilization restrictions as evidence that early mobilization is unsafe or ineffective. The survey reports that these restrictions are driven by heterogeneous practices and lack of protocols, not by proven harm from mobilization.

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