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The following is a summary of “Assessing the impact of early progressive mobilization on moderate-to-severe traumatic brain injury: a randomized controlled trial,” published in the May 2024 issue of Critical Care by Yen et al.

Despite extensive studies highlighting the importance of early rehabilitation for moderate patients with traumatic brain injury (TBI), the best timing and methods for early mobilization after a TBI are still unclear.

Researchers conducted a retrospective study to assess how early progressive mobilization (EPM) protocols influence functional recovery in ICU patients with moderate to severe TBI.

They conducted a randomized controlled trial in a trauma ICU; 65 patients were randomly split between the EPM and early progressive upright positioning (EPUP) groups. In the EPM group, patients received early out-of-bed mobilization therapy within seven days post-injury, while in the EPUP group underwent early in-bed upright position rehabilitation. The primary outcome measured was the Perme ICU Mobility Score, with secondary outcomes including Functional Independence Measure motor domain (FIM-motor) score, phase angle (PhA), skeletal muscle index (SMI), length of stay in the ICU, and duration of ventilation.

The results showed that out of 65 randomized patients, 33 were assigned to the EPM group and 32 to the EPUP group. The EPM group demonstrated significantly better performance in the Perme ICU Mobility and FIM-motor scores, with a notable reduction in ICU stay by 5.9 days (P<0.001) and ventilation duration by 6.7 days (P=0.001). However, no significant disparities were noted in PhAs.

Investigators found that an early program for getting patients out of bed after moderate-to-severe TBI improved mobility, function, ICU stay, and ventilation time, suggesting a need for more extensive trials.

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04940-0