Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible
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...
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doaj-777fcd45aa5c4472b539bc9334b5df572021-04-14T04:31:37ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-04-011210.3389/fneur.2021.626014626014Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is FeasibleChristian Gunge Riberholt0Christian Gunge Riberholt1Markus Harboe Olsen2Markus Harboe Olsen3Christian Baastrup Søndergaard4Christian Gluud5Christian Gluud6Christian Ovesen7Christian Ovesen8Janus Christian Jakobsen9Janus Christian Jakobsen10Jesper Mehlsen11Kirsten Møller12Kirsten Møller13Traumatic Brain Injury Unit, Department of Neurorehabilitation, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Neuroanaesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkDepartment of Neurosurgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkCopenhagen Trial Unit, Department 7812, Centre for Clinical Intervention Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, DenmarkDepartment of Regional Health Research, The Faculty of Heath Sciences, University of Southern Denmark, Odense, DenmarkCopenhagen Trial Unit, Department 7812, Centre for Clinical Intervention Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, DenmarkDepartment of Neurology, Bispebjerg and Frederiksberg Hospital, Copenhagen, DenmarkCopenhagen Trial Unit, Department 7812, Centre for Clinical Intervention Research, Copenhagen University Hospital-Rigshospitalet, Copenhagen, DenmarkDepartment of Regional Health Research, The Faculty of Heath Sciences, University of Southern Denmark, Odense, DenmarkSurgical Pathophysiology Unit, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, DenmarkDepartment of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Neuroanaesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: 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.https://www.frontiersin.org/articles/10.3389/fneur.2021.626014/fullearly mobilizationtraumatic brain injuryfeasibility trialhead-up tiltadverse events |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Christian Gunge Riberholt Christian Gunge Riberholt Markus Harboe Olsen Markus Harboe Olsen Christian Baastrup Søndergaard Christian Gluud Christian Gluud Christian Ovesen Christian Ovesen Janus Christian Jakobsen Janus Christian Jakobsen Jesper Mehlsen Kirsten Møller Kirsten Møller |
spellingShingle |
Christian Gunge Riberholt Christian Gunge Riberholt Markus Harboe Olsen Markus Harboe Olsen Christian Baastrup Søndergaard Christian Gluud Christian Gluud Christian Ovesen Christian Ovesen Janus Christian Jakobsen Janus Christian Jakobsen Jesper Mehlsen Kirsten Møller Kirsten Møller Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible Frontiers in Neurology early mobilization traumatic brain injury feasibility trial head-up tilt adverse events |
author_facet |
Christian Gunge Riberholt Christian Gunge Riberholt Markus Harboe Olsen Markus Harboe Olsen Christian Baastrup Søndergaard Christian Gluud Christian Gluud Christian Ovesen Christian Ovesen Janus Christian Jakobsen Janus Christian Jakobsen Jesper Mehlsen Kirsten Møller Kirsten Møller |
author_sort |
Christian Gunge Riberholt |
title |
Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible |
title_short |
Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible |
title_full |
Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible |
title_fullStr |
Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible |
title_full_unstemmed |
Early Orthostatic Exercise by Head-Up Tilt With Stepping vs. Standard Care After Severe Traumatic Brain Injury Is Feasible |
title_sort |
early orthostatic exercise by head-up tilt with stepping vs. standard care after severe traumatic brain injury is feasible |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2021-04-01 |
description |
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. |
topic |
early mobilization traumatic brain injury feasibility trial head-up tilt adverse events |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2021.626014/full |
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