Key result
Early mobilization improves discharge functional status by ~1.4 mRS points after subarachnoid hemorrhage.
Why the study?
The safety and efficacy of early mobilization in patients with aneurysmal subarachnoid haemorrhage were uncertain.
Does early mobilization improve functional status and reduce cerebral vasospasm in adult patients with aneurysmal subarachnoid haemorrhage?
Systematic Review (n=1,757)
Does early mobilization improve functional status and reduce cerebral vasospasm in adult patients with aneurysmal subarachnoid haemorrhage?
Early mobilization in aneurysmal subarachnoid hemorrhage is safe and associated with improved short-term functional outcomes and significantly lower rates of both clinical and radiological cerebral vasospasm.
Supports early mobilization in aneurysmal subarachnoid hemorrhage; extends mixed RCT-observational evidence to functional gains and vasospasm reduction.
OBJECTIVE: The primary aim of this study was to evaluate the safety and efficacy of early mobilization in patients with aneurysmal subarachnoid haemorrhage. DESIGN: Systematic review with meta-analysis of randomized controlled studies and observational studies. PATIENTS: Patients with aneurysmal subarachnoid haemorrhage. METHODS: PubMed, Embase, CINAHL, Web of Science, Pedro, and the Cochrane Library databases were searched. A systematic review and meta-analysis were performed. Screening and data extraction were performed by 2 independent reviewers. RESULTS: Sixteen studies involving 1,757 patients were included. Meta-analysis of the data estimated that early mobilization improved mRS score at discharge (mean difference -1.39, 95% CI -2.51 to -0.28, I2 = 86%) and at 3 months (mean difference -1.10, 95% CI -1.54 to -0.66, I2 = 7%). Early mobilization was associated with a reduction in cerebral vasospasm rate, both radiological (OR 0.66, 95% CI 0.45 to 0.96, I2 = 7%) and clinical (OR 0.44, 95% CI 0.27 to 0.72, I2 = 8%); 6% of mobilization sessions involved adverse events, mostly haemodynamic changes. CONCLUSION: This review found moderate-quality evidence supporting the safety and effectiveness of early mobilization in patients with SAH. Further randomized controlled trials are needed to identify the appropriate mobilization strategy and confirm these results.
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Foudhaïli et al. (2024) conducted a systematic review in Aneurysmal subarachnoid haemorrhage (n=1,757). Early mobilization vs. Delayed mobilization or no mobilization was evaluated on Modified Rankin Scale (mRS) score at discharge (MD -1.39, 95% CI -2.51 to -0.28). Early mobilization improved functional status at discharge (MD -1.39) and at 3 months, and reduced the rate of radiological and clinical cerebral vasospasm in patients with subarachnoid haemorrhage.
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