Abstract T MP41: Early Mobilization in Aneurysmal Subarachnoid Hemorrhage Accelerates the Recovery of Function

Abstract

Background and Purpose: Survivors of aneurysmal subarachnoid hemorrhage (SAH) are faced with a complicated recovery that typically includes surgery, prolonged monitoring in intensive care and treatment focusing on the prevention of complications. Aware of the complications resulting from bed rest and immobility, our multidisciplinary neurocritical care team developed an early mobilization program for patients with aneurysmal SAH. The purpose of this study was to determine the effects of early mobilization on patient function and participation in rehabilitation. Methods: A retrospective analysis was conducted on 93 patients diagnosed with aneurysmal SAH. Fifty-five patients received early mobilization after aneurysm treatment by a physical therapist or occupational therapist in the neurosurgical intensive care unit. Early mobilization focused on functional training and therapeutic exercise in progressively upright positions. Participation criteria ensured neurologic and physiologic stability prior to the initiation of early mobilization program sessions. Outcomes were compared to a control group of 38 patients that received care prior to the implementation of the early mobilization program. Data was analyzed using an independent two-tailed t- test. A p value of less than .05 was accepted as significant. Results: Demographic and clinical characteristics between the two groups were similar (p>.05). The number of days from admission to participation in out of bed activity decreased in the early mobilization group ( =4.2) compared to the control group ( =6.4, p=.039). The number of days from admission to walking (50 feet or greater) decreased in the early mobilization group ( =6.4) compared to the control group ( =10.5, p=.004). A greater number of sessions that included out of bed activity were observed in the early mobilization group ( =6.5) compared to the control group ( =4.4, p=.013). An increase in the number of sessions that included walking (50 feet or greater) was observed in the early mobilization group but was not significant. Conclusion: Patients with aneurysmal SAH receiving early mobilization participated in out of bed and walking activity faster and achieved a higher level of function during rehabilitation sessions.