@article{ref1,
title="The timeframe for safe resumption of high-level mobility following traumatic brain injury is currently unknown: a systematic review",
journal="Disability and rehabilitation",
year="2021",
author="Gallow, Sara and Hilet, Laura and Sutherland, Edwina and McGinley, Jennifer and Olver, John and Williams, Gavin",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: To examine the safety of high-level mobility (HLM) prescription in the early sub-acute phase of recovery following moderate-to-extremely severe traumatic brain injury (TBI) with specific focus on provocation of concussion-like symptoms. <br><br>DESIGN: Systematic review. PROSPERO ID: CRD42017069369. MAIN MEASURES: Extracted data included study design, brain injury severity, time to commence HLM, type of HLM, physiological and symptom monitoring, and rate of adverse events. <br><br>RESULTS: Nineteen studies were included in the review. Fifteen studies included participants who commenced HLM within 6 weeks of injury, with the earliest time to commencement being 3 days. Overall, adverse events and symptom monitoring were poorly reported. A total of six adverse events were reported across three studies. One of the six adverse events was a concussion-like symptom. No falls were reported. No studies monitored concussion-like symptom provocation in direct relation to HLM. <br><br>CONCLUSION: A safe timeframe for return to HLM after moderate-to-extremely severe TBI could not be determined due to insufficient reporting of symptom monitoring and adverse events. Further research into the safety of HLM in the early sub-acute rehabilitative stage after moderate-to-extremely severe TBI is required in order to better understand potential sequelae in this population.IMPLICATIONS FOR REHABILITATIONHigh-level mobility assessment and training is commonly reported in the early sub-acute phase of recovery following moderate-to-extremely severe traumatic brain injury.There is no consensus on a safe timeframe to commence high-level mobility assessment or training after moderate-to-extremely severe traumatic brain injury.High-level mobility assessment and training appears to be safe in the early sub-acute phase following moderate-to-extremely severe traumatic brain injury, however, adverse events and symptoms are poorly reported.Clinicians should continue to proceed with caution when assessing and prescribing high-level mobility for patients with moderate-to-extremely severe traumatic brain injury in the early sub-acute phase of recovery and monitor for risks such as falls and exacerbation of concussion-like symptoms.<p /> <p>Language: en</p>",
language="en",
issn="0963-8288",
doi="10.1080/09638288.2021.1936220",
url="http://dx.doi.org/10.1080/09638288.2021.1936220"
}