Sympathetic activity and early mobilization in patients in intensive and intermediate care with severe brain injuries: a preliminary prospective randomized study.

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Version: Final published version
Serval ID
serval:BIB_3804BA3F3ECA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sympathetic activity and early mobilization in patients in intensive and intermediate care with severe brain injuries: a preliminary prospective randomized study.
Journal
BMC neurology
Author(s)
Rocca A., Pignat J.M., Berney L., Jöhr J., Van de Ville D., Daniel R.T., Levivier M., Hirt L., Luft A.R., Grouzmann E., Diserens K.
ISSN
1471-2377 (Electronic)
ISSN-L
1471-2377
Publication state
Published
Issued date
13/09/2016
Peer-reviewed
Oui
Volume
16
Pages
169
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial
Publication Status: epublish
Abstract
Patients who experience severe brain injuries are at risk of secondary brain damage, because of delayed vasospasm and edema. Traditionally, many of these patients are kept on prolonged bed rest in order to maintain adequate cerebral blood flow, especially in the case of subarachnoid hemorrhage. On the other hand, prolonged bed rest carries important morbidity. There may be a clinical benefit in early mobilization and our hypothesis is that early gradual mobilization is safe in these patients. The aim of this study was to observe and quantify the changes in sympathetic activity, mainly related to stress, and blood pressure in gradual postural changes by the verticalization robot (Erigo®) and after training by a lower body ergometer (MOTOmed-letto®), after prolonged bed rest of minimum 7 days.
Thirty patients with severe neurological injuries were randomized into 3 groups with different protocols of mobilization: Standard, MOTOmed-letto® or Erigo® protocol. We measured plasma catecholamines, metanephrines and blood pressure before, during and after mobilization.
Blood pressure does not show any significant difference between the 3 groups. The analysis of the catecholamines suggests a significant increase in catecholamine production during Standard mobilization with physiotherapists and with MOTOmed-letto® and no changes with Erigo®.
This preliminary prospective randomized study shows that the mobilization of patients with severe brain injuries by means of Erigo® does not increase the production of catecholamines. It means that Erigo® is a well-tolerated method of mobilization and can be considered a safe system of early mobilization of these patients. Further studies are required to validate our conclusions.
The study was registered in the ISRCTN registry with the trial registration number ISRCTN56402432 . Date of registration: 08.03.2016. Retrospectively registered.

Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Blood Pressure/physiology, Brain Injuries/physiopathology, Brain Injuries/rehabilitation, Catecholamines/blood, Early Ambulation, Female, Humans, Male, Middle Aged, Physical Therapy Modalities, Young Adult
Pubmed
Open Access
Yes
Create date
23/09/2016 18:13
Last modification date
20/08/2019 13:26
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