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Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible

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@article{03f1b30af4a146eb8f03a96f2a126c6d,
title = "Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible",
abstract = "Background: Intensive rehabilitation of patients after severe traumatic brain injury aims to improve functional outcome. The effect of initiating rehabilitation in the early phase, in the form of head-up mobilization, is unclear. Objective: To assess whether early mobilization is feasible and safe in patients with traumatic brain injury admitted to a neurointensive care unit. Methods: This was a randomized parallel-group clinical trial, including patients with severe traumatic brain injury (Glasgow coma scale <11 and admission to the neurointensive care unit). The intervention consisted of daily mobilization on a tilt-table for 4 weeks. The control group received standard care. Outcomes were the number of included participants relative to all patients with traumatic brain injury who were approached for inclusion, the number of conducted mobilization sessions relative to all planned sessions, as well as adverse events and reactions. Information on clinical outcome was collected for exploratory purposes. Results: Thirty-eight participants were included (19 in each group), corresponding to 76% of all approached patients [95% confidence interval (CI) 63-86%]. In the intervention group, 74% [95% CI 52-89%] of planned sessions were carried out. There was no difference in the number of adverse events, serious adverse events, or adverse reactions between the groups. Conclusions: Early head-up mobilization is feasible in patients with severe traumatic brain injury. Larger randomized clinical trials are needed to explore potential benefits and harms of such an intervention. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT02924649]. Registered on 3rd October 2016.",
keywords = "adverse events, early mobilization, feasibility trial, head-up tilt, traumatic brain injury",
author = "Riberholt, {Christian Gunge} and Olsen, {Markus Harboe} and S{\o}ndergaard, {Christian Baastrup} and Christian Gluud and Christian Ovesen and Jakobsen, {Janus Christian} and Jesper Mehlsen and Kirsten M{\o}ller",
note = "Copyright {\textcopyright} 2021 Riberholt, Olsen, S{\o}ndergaard, Gluud, Ovesen, Jakobsen, Mehlsen and M{\o}ller.",
year = "2021",
month = apr,
day = "14",
doi = "10.3389/fneur.2021.626014",
language = "English",
volume = "12",
pages = "626014",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Research Foundation",

}

RIS

TY - JOUR

T1 - Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible

AU - Riberholt, Christian Gunge

AU - Olsen, Markus Harboe

AU - Søndergaard, Christian Baastrup

AU - Gluud, Christian

AU - Ovesen, Christian

AU - Jakobsen, Janus Christian

AU - Mehlsen, Jesper

AU - Møller, Kirsten

N1 - Copyright © 2021 Riberholt, Olsen, Søndergaard, Gluud, Ovesen, Jakobsen, Mehlsen and Møller.

PY - 2021/4/14

Y1 - 2021/4/14

N2 - Background: Intensive rehabilitation of patients after severe traumatic brain injury aims to improve functional outcome. The effect of initiating rehabilitation in the early phase, in the form of head-up mobilization, is unclear. Objective: To assess whether early mobilization is feasible and safe in patients with traumatic brain injury admitted to a neurointensive care unit. Methods: This was a randomized parallel-group clinical trial, including patients with severe traumatic brain injury (Glasgow coma scale <11 and admission to the neurointensive care unit). The intervention consisted of daily mobilization on a tilt-table for 4 weeks. The control group received standard care. Outcomes were the number of included participants relative to all patients with traumatic brain injury who were approached for inclusion, the number of conducted mobilization sessions relative to all planned sessions, as well as adverse events and reactions. Information on clinical outcome was collected for exploratory purposes. Results: Thirty-eight participants were included (19 in each group), corresponding to 76% of all approached patients [95% confidence interval (CI) 63-86%]. In the intervention group, 74% [95% CI 52-89%] of planned sessions were carried out. There was no difference in the number of adverse events, serious adverse events, or adverse reactions between the groups. Conclusions: Early head-up mobilization is feasible in patients with severe traumatic brain injury. Larger randomized clinical trials are needed to explore potential benefits and harms of such an intervention. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT02924649]. Registered on 3rd October 2016.

AB - Background: Intensive rehabilitation of patients after severe traumatic brain injury aims to improve functional outcome. The effect of initiating rehabilitation in the early phase, in the form of head-up mobilization, is unclear. Objective: To assess whether early mobilization is feasible and safe in patients with traumatic brain injury admitted to a neurointensive care unit. Methods: This was a randomized parallel-group clinical trial, including patients with severe traumatic brain injury (Glasgow coma scale <11 and admission to the neurointensive care unit). The intervention consisted of daily mobilization on a tilt-table for 4 weeks. The control group received standard care. Outcomes were the number of included participants relative to all patients with traumatic brain injury who were approached for inclusion, the number of conducted mobilization sessions relative to all planned sessions, as well as adverse events and reactions. Information on clinical outcome was collected for exploratory purposes. Results: Thirty-eight participants were included (19 in each group), corresponding to 76% of all approached patients [95% confidence interval (CI) 63-86%]. In the intervention group, 74% [95% CI 52-89%] of planned sessions were carried out. There was no difference in the number of adverse events, serious adverse events, or adverse reactions between the groups. Conclusions: Early head-up mobilization is feasible in patients with severe traumatic brain injury. Larger randomized clinical trials are needed to explore potential benefits and harms of such an intervention. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT02924649]. Registered on 3rd October 2016.

KW - adverse events

KW - early mobilization

KW - feasibility trial

KW - head-up tilt

KW - traumatic brain injury

U2 - 10.3389/fneur.2021.626014

DO - 10.3389/fneur.2021.626014

M3 - Journal article

C2 - 33935935

VL - 12

SP - 626014

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 626014

ER -

ID: 65750312