Rehabilitation in the Intensive Care Unit for Adults with Traumatic Brain Injury: A Systematic Review and Meta-analysis.
Fiona Howroyd, David McWilliams, Jonathan Weblin et al.
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In 30 seconds
This systematic review and meta-analysis assessed the safety and outcomes of physical rehabilitation in adults with acute traumatic brain injury admitted to intensive care. It included 13 studies involving 3582 adults. Four studies reported safety outcomes, with no or low rates of adverse events. In pooled analysis, rehabilitation was associated with higher Perme ICU Mobility Scores at ICU discharge than no rehabilitation (mean difference 3.25 [2.05-4.44], p < 0.00001). The authors judged rehabilitation potentially safe, while noting substantial risk of bias and the need for higher-quality studies.
Key findings
- Four studies reported safety outcomes, describing no or low rates of adverse events.
- Rehabilitation was associated with higher Perme ICU Mobility Scores at ICU discharge: mean difference 3.25 (2.05-4.44), p < 0.00001.
- Risk of bias was very high in observational studies and raised some concerns in randomised studies.
Why it matters
ICU rehabilitation may be feasible for adults with TBI and could improve mobility by the time of ICU discharge. The findings offer a basis for considering rehabilitation within critical care, but the evidence remains uncertain because of bias and the limited number of studies reporting safety outcomes.
What to keep in mind
The evidence included studies at very high risk of bias among observational designs and with some concerns in randomised studies; only four studies reported safety outcomes.