Brain Disorders & Therapy

Effectiveness of a very early stepping verticalization protocol in severe acquired Brain injured Patients: A randomized pilot study in ICU

2^nd International Conference on Brain Disorders and Therapeutics

Chicago, USA October 26-28, 2016

Ilaria Zivi, Giuseppe Frazzitta, Roberto Valsecchi, Sara Bonini, Sara Maffia1, Katia Molatore, Luca Sebastianelli, Alessio Zarucchi, Diana Matteri, Giuseppe Ercoli, Roberto Maestri and Leopold Saltuari

Ospedale �??Moriggia-Pelascini�?�, Gravedona ed Uniti (CO), Italy
Fondazione S. Maugeri IRCCS, Italy
Landeskrankenhaus Hochzirl-Natters, Austria

Scientific Tracks Abstracts: Brain Disord Ther

Abstract:

Background and Objective: Verticalization was reported to improve the level of arousal and awareness in patients with severe acquired brain injury (ABI) and to be safe in ICU. We evaluated the effectiveness of a very early stepping verticalization protocol on their functional and neurological outcome Methods: Consecutive patients with vegetative State or Minimally Conscious State were enrolled in ICU on the third day after an ABI. They were randomized to undergo conventional physiotherapy alone or associated to fifteen 30-minute sessions of verticalization, using a tilt table with robotic stepping device. Once stabilized, patients were transferred to our Neurorehabilitation unit for an individualized treatment. Outcome measures (Glasgow Coma Scale, Coma Recovery Scale revised -CRSr-, Disability Rating Scale �??DRS- and Levels of Cognitive Functioning) were assessed on the third day from the injury (T0), at ICU discharge (T1) and at Rehab discharge (T2). Between- and within-group comparisons were performed by the Mann-Whitney U test and Wilcox on signed-rank test, respectively Results: Of the 40 patients enrolled, 31 completed the study without adverse events (15 in the verticalization group and 16 in the conventional physiotherapy). Early verticalization started 12.4±7.3 (mean±SD) days after ABI. The length of stay in ICU was longer for the verticalization group (38.8 ± 15.7 vs 25.1 ± 11.2 days, p=0.01), while the total length of stay (ICU + Neurorehabilitation) was not significantly different (153.2 ± 59.6 vs 134.0 ± 61.0 days, p=0.41). All outcome measures significantly improved in both groups after the overall period (T2 vs T0, p<0.001 all), as well as after ICU stay (T1 vs T0, p<0.004 all) and after Neurorehabilitation (T2 vs T1, p<0.004 all). The improvement was significantly better in the experimental group for CRSr (T2-T0 p=0.033, T1-T0 p=0.006) and (borderline) for DRS (T2-T0 p=0.040, T1-T0 p=0.058) Conclusions: A stepping verticalization protocol, started since the acute stages, improves the short-term and long-term functional and neurological outcome of ABI patients

Biography :

Email: ilaria.zivi@gmail.com