Observational studyNeurocritical care2019
Safety and Feasibility of Early Mobilization in Patients with Subarachnoid Hemorrhage and External Ventricular Drain.
Observational study in Neurocritical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- A physiotherapy protocol* for stroke patients in acute hospital settings: expert consensus from the Brazilian early stroke rehabilitation task force.Arquivos de neuro-psiquiatria · 2025Guideline
- Early mobilization in patients with aneurysmal subarachnoid haemorrhage may im-prove functional status and reduce cerebral vasospasm rate: a systematic review with meta-analysis.Journal of rehabilitation medicine · 2024Pooled it
- Neuromuscular Electrical Stimulation and High-Protein Supplementation After Subarachnoid Hemorrhage: A Single-Center Phase 2 Randomized Clinical Trial.Neurocritical care · 2021Trial
- Early rehabilitation initiation after aneurysmal subarachnoid haemorrhage: evaluation of mortality and functional outcomes.European stroke journal · 2026Article
- Early mobilization in patients with aneurysmal subarachnoid hemorrhage: a prospective observational study.Physical therapy · 2026Observational
- Prevention and Treatment of ICU Delirium in Brain Injured Patients.Current neurology and neuroscience reports · 2026Review
- [Early mobilization in the intensive care unit for patients with subarachnoid hemorrhage-a review].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Intracranial Pressure During Mobilization in a Patient With Postoperative Putaminal Hemorrhage: A Case Report.Cureus · 2025Article
- Safety of Early Mobilization in Adult Neurocritical Patients: An Exploratory Review.Critical care research and practice · 2025Review
- Serum C-reactive protein value on day 14 as a possible prognostic factor of aneurysmal subarachnoid hemorrhage.The Journal of international medical research · 2024Article
- Cardiac rehabilitation after cardiac surgery: An important underutilized treatment strategy.World journal of cardiology · 2024Article
- External Ventricular Drain Placement, Critical Care Utilization, Complications, and Clinical Outcomes after Spontaneous Subarachnoid Hemorrhage: A Single-Center Retrospective Cohort Study.Journal of clinical medicine · 2024Article
- Early mobilization of patients with subarachnoid haemorrhage: a national survey of french intensive care units.Journal of rehabilitation medicine · 2024Article
- Evidence and Recommendations for Acute Stroke Rehabilitation from the Japan Stroke Society: Abridged Secondary Publication of the Japanese-language Version.Progress in rehabilitation medicine · 2024Article
- Mobilization phases in traumatic brain injury.Acute and critical care · 2023Article
- Predictors of In-Hospital Mortality and Home Discharge in Patients with Aneurysmal Subarachnoid Hemorrhage: A 4-Year Retrospective Analysis.Neurocritical care · 2023Article
- Huge variability in restrictions of mobilization for patients with aneurysmal subarachnoid hemorrhage - A European survey of practice.Brain & spine · 2023Article
- External Ventricular Drains: Development and Evaluation of a Nursing Clinical Practice Guideline.Nursing reports (Pavia, Italy) · 2022Article
- Mobilization of Children with External Ventricular Drains: A Retrospective Cohort Study.Children (Basel, Switzerland) · 2022Article
- Hierarchical Cluster Analysis Identifies Distinct Physiological States After Acute Brain Injury.Neurocritical care · 2022Observational
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND/
objectiveIn November 2014, our Neurointensive Care Unit began a multi-phased progressive early mobilization initiative for patients with subarachnoid hemorrhage and an external ventricular drain (EVD). Our goal was to transition from a culture of complete bed rest (Phase 0) to a physical and occupational therapy (PT/OT)-guided mobilization protocol (Phase I), and ultimately to a nurse-driven mobilization protocol (Phase II). We hypothesized that nurses could mobilize patients as safely as an exclusively PT/OT-guided approach.
methodsIn Phase I, patients were mobilized only with PT/OT at bedside; no independent time out of bed occurred. In Phase II, nurses independently mobilized patients with EVDs, and patients could remain out of bed for up to 3 h at a time. Physical and occupational therapists continued routine consultation during Phase II.
resultsPhase II patients were mobilized more frequently than Phase I patients [7.1 times per ICU stay (± 4.37) versus 3.0 times (± 1.33); p = 0.02], although not earlier [day 4.9 (± 3.46) versus day 6.0 (± 3.16); p = 0.32]. All Phase II patients were discharged to home PT services or acute rehabilitation centers. No patients were discharged to skilled nursing or long-term acute care hospitals, versus 12.5% in Phase I. In a multivariate analysis, odds of discharge to home/rehab were 3.83 for mobilized patients, independent of age and severity of illness. Other quality outcomes (length of stay, ventilator days, tracheostomy placement) between Phase I and Phase II patients were similar. No adverse events were attributable to early mobilization.
conclusionsNurse-driven mobilization for patients with EVDs is safe, feasible, and leads to more frequent ambulation compared to a therapy-driven protocol. Nurse-driven mobilization may be associated with improved discharge disposition, although exact causation cannot be determined by these data.
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