title: Effect of passive range of motion on intracranial pressure in neurosurgical patients.
abstract: OBJECTIVE
  A prospective patient study was done to evaluate the effect of passive range of motion (PROM) on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in neurosurgical patients.
  
  
  METHODS
  Twelve adult patients admitted to the neurological-neurosurgical intensive care unit of a community teaching hospital were enrolled in the study. The study patients all required ICP monitoring and they underwent a total of 20 PROM sessions. Six patients (10 PROM sessions) were mechanically ventilated, and six patients (10 PROM sessions) were breathing spontaneously. Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), and ICP were measured at baseline and at 1-minute intervals during the physical therapy session. CPP was calculated as the difference between MAP and ICP.
  
  
  RESULTS
  No significant changes were detected in MAP, ICP, HR, or RR during the study period. Calculated CPP remained unchanged. Mean duration of PROM intervention was 7 +/- 1 minute. Mean Glasgow Coma Scale (GCS) for mechanically ventilated patients was 7 +/- 1.3 and for spontaneously breathing patients 13 +/- 0.8.
  
  
  CONCLUSIONS
  PROM results in no significant changes in ICP or CPP in stable, neurosurgical patients in the absence of intracranial hypertension.
authors.affiliation: Department of Anesthesiology, University of Texas Medical School, Houston, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Koch
authors.forename: S
authors.initials: S
authors.lastname: Fogarty
authors.forename: C
authors.initials: C
authors.lastname: Signorino
authors.forename: L
authors.initials: L
authors.lastname: Parmley
authors.forename: U
authors.initials: U
authors.lastname: Mehlhorn
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery / Q000534:rehabilitation*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012119:Respiration / Q000502:physiology; D012121:Respiration, Artificial