Early head-up mobilisation versus standard care for patients with severe acquired brain injury: A systematic review with meta-analysis and Trial Sequential Analysis
There is increasing focus on earlier rehabilitation in patients with traumatic or hypoxic brain injury or stroke. This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. We searched Medline, CENTRAL, EM...
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| Veröffentlicht in: | PloS one 2020-08, Vol.15 (8), p.e0237136-e0237136 |
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| creator | Riberholt, Christian Gunge Wagner, Vibeke Lindschou, Jane Gluud, Christian Mehlsen, Jesper Moller, Kirsten |
| description | There is increasing focus on earlier rehabilitation in patients with traumatic or hypoxic brain injury or stroke. This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. We searched Medline, CENTRAL, EMBASE, four other databases and 13 selected clinical trial registries until April 2020. Eligible randomised clinical trials compared early head-up mobilisation versus standard care in patients with severe acquired brain injury and were analysed conducting random- and fixed-effects meta-analyses and Trial Sequential Analysis (TSA). Certainty of evidence was assessed by GRADE. We found no evidence of a difference between early mobilisation versus standard care for patients with severe acquired brain injury. Early mobilisation appeared not to exert a major impact on quality of life. This systematic review highlights the insufficient evidence in patients with severe brain injury, and no firm conclusions can be drawn from these data. |
| doi_str_mv | 10.1371/journal.pone.0237136 |
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This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. We searched Medline, CENTRAL, EMBASE, four other databases and 13 selected clinical trial registries until April 2020. Eligible randomised clinical trials compared early head-up mobilisation versus standard care in patients with severe acquired brain injury and were analysed conducting random- and fixed-effects meta-analyses and Trial Sequential Analysis (TSA). Certainty of evidence was assessed by GRADE. We found no evidence of a difference between early mobilisation versus standard care for patients with severe acquired brain injury. Early mobilisation appeared not to exert a major impact on quality of life. This systematic review highlights the insufficient evidence in patients with severe brain injury, and no firm conclusions can be drawn from these data.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0237136</identifier><identifier>PMID: 32790771</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Brain ; Brain injuries ; Brain research ; Care and treatment ; Clinical medicine ; Clinical trials ; Head injuries ; Health risks ; Hospitals ; Hypoxia ; Injury analysis ; Medicine and Health Sciences ; Meta-analysis ; Methods ; Neurorehabilitation ; Patient outcomes ; Physical Sciences ; Quality of life ; Randomization ; Rehabilitation ; Research and Analysis Methods ; Risk ; Sequential analysis ; Stroke ; Systematic review ; Traumatic brain injury</subject><ispartof>PloS one, 2020-08, Vol.15 (8), p.e0237136-e0237136</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Riberholt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Riberholt et al 2020 Riberholt et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-141cec1936db716c3dd44e44bae521ff47f770916676760c47a4398d8d0be9523</citedby><cites>FETCH-LOGICAL-c669t-141cec1936db716c3dd44e44bae521ff47f770916676760c47a4398d8d0be9523</cites><orcidid>0000-0002-6170-1869</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425882/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425882/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids></links><search><contributor>Florez, Ivan D.</contributor><creatorcontrib>Riberholt, Christian Gunge</creatorcontrib><creatorcontrib>Wagner, Vibeke</creatorcontrib><creatorcontrib>Lindschou, Jane</creatorcontrib><creatorcontrib>Gluud, Christian</creatorcontrib><creatorcontrib>Mehlsen, Jesper</creatorcontrib><creatorcontrib>Moller, Kirsten</creatorcontrib><title>Early head-up mobilisation versus standard care for patients with severe acquired brain injury: A systematic review with meta-analysis and Trial Sequential Analysis</title><title>PloS one</title><description>There is increasing focus on earlier rehabilitation in patients with traumatic or hypoxic brain injury or stroke. This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. We searched Medline, CENTRAL, EMBASE, four other databases and 13 selected clinical trial registries until April 2020. Eligible randomised clinical trials compared early head-up mobilisation versus standard care in patients with severe acquired brain injury and were analysed conducting random- and fixed-effects meta-analyses and Trial Sequential Analysis (TSA). Certainty of evidence was assessed by GRADE. We found no evidence of a difference between early mobilisation versus standard care for patients with severe acquired brain injury. Early mobilisation appeared not to exert a major impact on quality of life. This systematic review highlights the insufficient evidence in patients with severe brain injury, and no firm conclusions can be drawn from these data.</description><subject>Brain</subject><subject>Brain injuries</subject><subject>Brain research</subject><subject>Care and treatment</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Head injuries</subject><subject>Health risks</subject><subject>Hospitals</subject><subject>Hypoxia</subject><subject>Injury analysis</subject><subject>Medicine and Health Sciences</subject><subject>Meta-analysis</subject><subject>Methods</subject><subject>Neurorehabilitation</subject><subject>Patient outcomes</subject><subject>Physical Sciences</subject><subject>Quality of life</subject><subject>Randomization</subject><subject>Rehabilitation</subject><subject>Research and Analysis Methods</subject><subject>Risk</subject><subject>Sequential analysis</subject><subject>Stroke</subject><subject>Systematic 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This systematic review evaluates the benefits and harms of early head-up mobilisation versus standard care in patients with severe acquired brain injury. We searched Medline, CENTRAL, EMBASE, four other databases and 13 selected clinical trial registries until April 2020. Eligible randomised clinical trials compared early head-up mobilisation versus standard care in patients with severe acquired brain injury and were analysed conducting random- and fixed-effects meta-analyses and Trial Sequential Analysis (TSA). Certainty of evidence was assessed by GRADE. We found no evidence of a difference between early mobilisation versus standard care for patients with severe acquired brain injury. Early mobilisation appeared not to exert a major impact on quality of life. 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| subjects | Brain Brain injuries Brain research Care and treatment Clinical medicine Clinical trials Head injuries Health risks Hospitals Hypoxia Injury analysis Medicine and Health Sciences Meta-analysis Methods Neurorehabilitation Patient outcomes Physical Sciences Quality of life Randomization Rehabilitation Research and Analysis Methods Risk Sequential analysis Stroke Systematic review Traumatic brain injury |
| title | Early head-up mobilisation versus standard care for patients with severe acquired brain injury: A systematic review with meta-analysis and Trial Sequential Analysis |
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