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Mobilization in early rehabilitation in intensive care unit patients with severe acquired brain injury

BARTOLO M; BARGELLESI S; CASTIONI CA; INTISO D; FONTANA A; COPETTI M; SCARPONI F; BONAIUTI D
J REHABIL MED , 2017, vol. 49, n° 9, p. 715-722
Doc n°: 185662
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.2340/16501977-2269
Descripteurs : AF3 - TRAUMATISME CRANIEN, AL - NEUROREEDUCATION

OBJECTIVE: To determine whether early mobilization of patients with severe
acquired brain injury, performed in the intensive/neurointensive care unit,
influences functional outcome. DESIGN: Prospective observational study. SETTING:
Fourteen centres in Italy. SUBJECTS: A total of 103 consecutive patients with
acquired brain injury. METHODS: Clinical, neurological and functional data,
including the Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), the Rancho
Los Amigos Levels of Cognitive Functioning (LCF), Early Rehabilitation Barthel
Index (ERBI), Glasgow Outcome Scale (GOS), and Functional Independence Measure
(FIM) were collected at admission and every 3?5 days until discharge from the
intensive/neurointensive care unit. Patients were divided into mobilization and
no mobilization groups, depending on whether they received mobilization. Data
were analysed by intragroup and intergroup analysis using a multilevel regression
model. RESULTS: Sixty-eight patients were included in the mobilization group. At
discharge, both groups showed significant improvements in GCS, DRS, LCF and ERBI
scores. The mobilization group showed significantly better improvements in FIM
cognitive, GOS and ERBI. The patients in the mobilization group stayed longer in
the intensive care unit (p=0.01) and were more likely to be discharged to
intensive rehabilitation at a significantly higher rate (p=0.002) than patients
in the no mobilization group. No adverse events were reported in either group.
CONCLUSION: Early mobilization appears to favour the clinical and functional
recovery of patients with severe acquired brain injury in the intensive care
unit.

Langue : ANGLAIS

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