Forskning
Udskriv Udskriv
Switch language
Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

Early head-up mobilisation versus standard care for patients with severe acquired brain injury: A systematic review with meta-analysis and Trial Sequential Analysis

Publikation: Bidrag til tidsskriftReviewForskningpeer review

  1. Novel functions of the luteinizing hormone/chorionic gonadotropin receptor in prostate cancer cells and patients

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Hepatitis C prevalence in Denmark in 2016-An updated estimate using multiple national registers

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Inflammation, non-endothelial dependent coronary microvascular function and diastolic function-Are they linked?

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Dyslipidemia at diagnosis of childhood acute lymphoblastic leukemia

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Background: There is increasing focus on earlier rehabilitation in patients with traumatic or hypoxic brain injury or stroke. This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. Methods: We searched Medline, CENTRAL, EMBASE, four other databases and 13 selected clinical trial registries until April 2020. Eligible randomised clinical trials compared early head-up mobilisation versus standard care in patients with severe acquired brain injury and were analysed conducting random- and fixed-effects meta-analyses and Trial Sequential Analysis (TSA). Certainty of evidence was assessed by GRADE. Main results: We identified four randomised clinical trials (total n = 385 patients) with severe acquired brain injury (stroke 86% and traumatic brain injury 13%). Two trials were at low risk and two at high risk of bias. We found no evidence of a difference between early mobilisation vs. standard care on mortality or poor functional outcome at end of the intervention (relative risk (RR) 1.19, 95% CI 0.93 to 1.53; I2 0%; very low certainty) or at maximal follow-up (RR 1.03, 95% CI 0.89 to 1.21; I2 0%; very low certainty). We found evidence against an effect on quality of life at maximal follow-up. The proportion of patients with at least one serious adverse event did not differ at end of intervention or at maximal follow-up. For most comparisons, TSA suggested that further trials are needed. Conclusions: We found no evidence of a difference between early mobilisation versus standard care for patients with severe acquired brain injury. Early mobilisation appeared not to exert a major impact on quality of life. This systematic review highlights the insufficient evidence in patients with severe brain injury, and no firm conclusions can be drawn from these data.

OriginalsprogEngelsk
Artikelnummere0237136
TidsskriftPLoS One
Vol/bind15
Udgave nummer8 August
ISSN1932-6203
DOI
StatusUdgivet - 13 aug. 2020

ID: 60681067