Abstract
Background 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.
Objective The purpose of this study was to determine the safety and feasibility of an early mobilization program for patients with aneurysmal SAH.
Design 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.
Footnotes
All authors provided concept/idea/research design. Dr Olkowski, Dr Slotnick, and Dr Arcaro provided writing and data analysis. Dr Olkowski, Dr Devine, Dr Slotnick, and Dr Arcaro provided data collection and project management. Dr Devine, Dr Veznedaroglu, Dr Liebman, and Dr Binning provided study participants. Dr Devine provided facilities/equipment, institutional liaisons, and consultation (including review of manuscript before submission).
This study was approved by the Capital Health Institutional Review Board.
- Received October 6, 2011.
- Accepted May 22, 2012.
