Early mobilisation of patients in the acute hospital setting following aneurysmal subarachnoid haemorrhage – A survey of current physiotherapy practice

Abstract

Aneurysmal subarachnoid haemorrhage is a catastrophic form of stroke. There is very limited literature to guide physiotherapists on the type and timing of mobility interventions that should be provided during the acute phase. The aim of this study was to determine the current practices of physiotherapists in early mobilisation of patients with aneurysmal subarachnoid haemorrhage. A purpose-designed electronic survey was distributed to 71 physiotherapists in hospitals that specialise in the management of aneurysmal subarachnoid haemorrhage throughout Australia and New Zealand. A response rate of 80% was obtained (n=57). Prior to the aneurysm being repaired, the most common practice reported by physiotherapists was not to mobilise patients (41%). Once the aneurysm was repaired, mobility goals increased with >80% of physiotherapists reporting goals of sitting on the edge of the bed or step transferring to a chair day one post repair. Physiotherapists reported that vasospasm, delayed cerebral ischaemia, recent further bleed, hypotension or the use of high level of noradrenaline would prevent them from mobilising patients. Only four respondents reported that they had a mobilisation protocol for aneurysmal subarachnoid haemorrhage patients at their hospital. Further research is required into the safety, timing and efficacy of early mobilisation practices in the management of aneurysmal subarachnoid haemorrhage patients.