Early ambulation improves activities of daily living and reduces hospitalization in aneurysmal subarachnoid hemorrhage patients

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS1238–eS1642

Research Report Poster Presentation Number: RR-PO-22-19-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 EARLY AMBULATION IMPROVES ACTIVITIES OF DAILY LIVING AND REDUCES HOSPITALIZATION IN ANEURYSMAL SUBARACHNOID HEMORRHAGE PATIENTS M. Uemura 1,2 , S. Kuwata 1 , Y. Yoshikawa 3 , N. Maeshige 2 , T. Inoue 2 , S. Natsume 1 , Y. Yoshida 4 , H. Matsumoto 4

eS1555

Conclusion(s): This study suggests that early ambulation improvements ADL, and reduces hospitalization in SAH patient. Implications: The number of subjects was small as twenty-five patients, and in this study, we showed the effects of early ambulation for an unspecified age and severity. Therefore, we have to increase the subjects and examine the effects of that in severe or old SAH patients. Keywords: SAH; Early ambulation; FIM Funding acknowledgements: No external funding was obtained for this study and there are no potential competing interests. Ethics approval: This study was not required ethics approval because of a retrospective study.

1 Yoshida

Hospital, Rehabilitation, Kobe, Japan; 2 Kobe University, Graduate School of Health Sciences, Kobe, Japan; 3 Day-care Facility, Miyabinosato, Akashi, Japan; 4 Yoshida Hospital, Neurosurgery, Kobe, Japan Background: Postoperative management of aneurysmal subarachnoid hemorrhage (SAH) is required prolonged monitoring in the intensive care unit and treatment focusing on the prevention of complications such as cerebral vasospasm. In Japan, a few studies show the effectiveness of early ambulation in SAH patients, and many SAH patients are in bed with drainages and catheters during two weeks in which the risk of cerebral vasospasm is high. Long-term bed rest leads to disuse syndrome and prolonged hospitalization, however, some physical therapists and occupational therapists hesitate in ambulation because of complications risk. In this study, we verify whether early ambulation improves activities of daily living (ADL) and reduces hospitalization without complications. Purpose: We evaluated the effects of early ambulation after the operation for ruptured cerebral aneurysms on the outcomes at discharge in SAH patients. Methods: A retrospective study was performed on data obtained from twenty-five patients with SAH (male; 7, female; 18) between March 2013 and March 2014. They were received early mobilization by physical therapists and occupational therapists. The patients were divided into two groups whether they could be transferred sitting within 13 days from the onset; 13 patients were defined as early ambulation (EA) group and 12 were delaying (DL) groups. Results: The motor FIM efficacy was significantly higher in EA group compared to DL group (p = 0.034), and the number of patients who discharged directly home was more in EA group than in DL group (p = 0.047). There was no significant correlation between early ambulation and development of complications such as cerebral vasospasm (p = 0.22), pneumonia (p = 0.096), and hydrocephalus (p = 0.097), suggesting that early ambulation does not lead to complications. The score of NIHSS, FIM efficacy and severity did not differ significantly between EA group and DL group (p > 0.05). These results suggest that early ambulation can improve physical function without increase of complications.

http://dx.doi.org/10.1016/j.physio.2015.03.1552 Research Report Poster Presentation Number: RR-PO-04-09-Mon Monday 4 May 2015 12:15 Exhibit halls 401–403 THE EFFECTS OF DIRECT MICRO-CURRENT STIMULATION ON THE PROLIFERATION OF HUMAN DERMAL FIBROBLASTS Y. Yoshikawa 1 , N. Maeshige 2 , M. Sugimoto 1 , M. Uemura 2 , R. Fujishima 1 , H. Shuntoh 1 1 Kobegakuin

University, Faculty of Rehabilitation, Kobe, Japan; 2 Kobe University, Graduate School of Health Sciences, Kobe, Japan Background: Electrical stimulation is recommended for several purposes, including the promotion of wound contraction by the Japanese Society of Pressure Ulcers. Although this effect has been reported in a number of clinical studies, the recommended parameters have not been clarified yet. Purpose: In this study, we examined the effective frequency of direct micro-current stimulation (DMCS) on the proliferation of human dermal fibroblasts. Methods: Fibroblasts with 7–8 passages were plated in tissue culture dishes, and randomized (double-blind) into five groups, including those of 0 Hz (control), 2 Hz, 8 Hz, 16 Hz or 64 Hz. At 24 h after cell plating, DMCS of 200 ␮A was applied for 1 hour using platinum electrodes in a CO2 incubator with microscopy, and repeated two times at 48 h and 72 h. We took pictures using time-lapse microscopy once per hour for 96 h after cell plating. Cell number was counted at the center area (@mm2 ) of tissue culture dishes, and cell densities were calculated at 24 h, 48 h, 72 h and 96 h after cell plating. We used trypan blue exclusion test to assess cell toxicity caused by DMCS. Differenced between the mean cell density of the control and intervention groups were analyzed by the single-step