Impact of Early Mobilization on Ambulation Recovery in Elderly and/or Patients with Severe Subarachnoid Hemorrhage: A Multicenter Retrospective Study

Shota SUZUKI; Hikaru TAKARA; Shuhei SATOH; Yoko ABE; Shohei MIYAZATO; Mayu HAMADA; Yuki ISHIKAWA; Shin MINAKATA; Masamichi MORIYA; Shigeru OBAYASHI

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Impact of Early Mobilization on Ambulation Recovery in Elderly and/or Patients with Severe Subarachnoid Hemorrhage: A Multicenter Retrospective Study

VernacularTitle:高齢・重症くも膜下出血患者に対する早期離床が歩行再獲得に与える影響─多施設後方視研究─
Author: Shota SUZUKI ¹ ; Hikaru TAKARA ² ; Shuhei SATOH ³ ; Yoko ABE ⁴ ; Shohei MIYAZATO ² ; Mayu HAMADA ¹ ; Yuki ISHIKAWA ¹ ; Shin MINAKATA ⁵ ; Masamichi MORIYA ⁶ ; Shigeru OBAYASHI ¹
Author Information

1. Department of Rehabilitation, Saitama Medical Center, Saitama Medical University
2. Department of Rehabilitation, Naha City Hospital
3. Department of Rehabilitation, Akita Cerebrospinal and Cardiovascular Center
4. Department of Rehabilitation, Sapporo Shiroishi Memorial Hospital
5. Department of Rehabilitation Medicine, Akita University Hospital
6. Department of Autonomic Neuroscience, Tokyo Metropolitan Institute of Gerontology
Keywords: acute phase rehabilitation; severity; age; sitting square; prognosis
From:The Japanese Journal of Rehabilitation Medicine 2025;():23065-
CountryJapan
Language:Japanese
Abstract: Objective: To clarify whether early mobilization is a predictive factor for ambulation recovery in elderly patients and/or patients with severe subarachnoid hemorrhage (SAH).Methods: This multicenter retrospective observational study included 471 patients with treated SAH (Group 1). We focused on SAH patients with a poor prognosis, including a subgroup of elderly SAH patients (age>65 years:n=203) (Group 2) and patients with severe SAH (World Federation of Neurological Societies [WFNS] grade IV or V:n=117) (Group 3). The chi-square test and Mann-Whitney U test were used to compare the differences between the ambulation recovery group and the non-recovery group. Multivariable logistic regression analysis modeling was used to estimate odds ratios and 95% confidence intervals of early mobilization for the ambulation-recovered group within 30 days of onset compared with the unrecovered group. Other covariates examined as possible confounders of the outcome were age, sex, location of the ruptured aneurysm, modified Fisher scale score, WFNS grade, mode of treatment (surgical vs. endovascular), duration of cerebrospinal fluid drainage, days on mechanical ventilation, intracerebral hemorrhage, symptomatic cerebral vasospasm, complications, shunt placement for hydrocephalus, and time to start mobilization.Results: Early mobilization was an independent predictive factor for gait recovery in all groups. Furthermore, location of the ruptured aneurysm (anterior circulation), absence of complications, and absence of shunt placement were independent factors for ambulation recovery in all groups.Conclusion: Early mobilization in elder or/and sever patients with SAH may be a predictive factor for ambulation recovery within 30 days of onset.