Article

Survivors of aneurysmal subarachnoid hemorrhage (SAH) are faced with
a complicated recovery, which typically includes surgery, prolonged monitoring in
the intensive care unit, and treatment focusing on the prevention of
complications. The purpose of this study was to determine the safety
and feasibility of an early mobilization program for patients with aneurysmal
SAH. This study was a retrospective analysis. METHODS: Twenty-five
patients received early mobilization by a physical therapist or an occupational
therapist, or both, which focused on functional training and therapeutic exercise
in more progressively upright positions. Participation criteria focused on
neurologic and physiologic stability prior to the initiation of early
mobilization program sessions. RESULTS: Patients met the criteria for
participation in 86.1% of the early mobilization program sessions attempted.
Patients did not meet criteria for the following reasons: Lindegaard ratio >3.0
or middle cerebral artery (MCA) mean flow velocity (MFV) >120 cm/s (8.1%), mean
arterial pressure (MAP) <80 mm Hg (1.8%), intracranial pressure (ICP) >15 mm Hg
(1.8%), unable to open eyes in response to voice (0.9%), respiratory rate >40
breaths/min (0.6%), MAP >110 mm Hg (0.3%), and heart rate <40 bpm (0.3%). Adverse
events occurred in 5.9% of early mobilization program sessions for the following
reasons: MAP <70 mm Hg (3.1%) or >120 mm Hg (2.4%) and heart rate >130 bpm
(0.3%). The 30-day mortality rate for all patients was 0%. Participation in the
early mobilization program began a mean of 3.2 days (SD=1.3) after aneurysmal
SAH, and patients received an average of 11.4 sessions (SD=4.3). Patients
required a mean of 5.4 days (SD=4.2) to participate in out-of-bed activity and a
mean of 10.7 days (SD=6.2) to walk >/=15.24 m (50 ft). CONCLUSIONS: The results
of this study suggest that an early mobilization program for patients with
aneurysmal SAH is safe and feasible.

Langue : ANGLAIS