title: Early rehabilitation in patients with acute aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  The aim of this study was to describe and quantify the content of early rehabilitation adapted to patients with acute aneurysmal subarachnoid hemorrhage (aSAH) and to assess its feasibility.
  
  
  METHODS
  This was a prospective, observational study including 37 aSAH patients. Early rehabilitation was applied according to a mobilization algorithm. Clinical parameters, the time that rehabilitation team used on early rehabilitation and progression in mobilization were recorded. The patients' clinical conditions were graded according to the World Federation of Neurological Surgeons scale (WFNS).
  
  
  RESULTS
  Poor-grade patients (WFNS 3, 4, 5) (n = 12) received more rehabilitation (median 412 min) than did good-grade patients (WFNS 1, 2) (median 240 min). Mobilization to 60° of head elevation in good-grade patients began on day one after securing the aneurysm. Out-of-bed mobilization was possible on day three. Poor-grade patients were mobilized to 60° after two days and were out of bed on day seven. At discharge, 67% of poor-grade patients were mobilized to walking versus 78% of good-grade patients. No serious adverse effects to early rehabilitation were observed.
  
  
  CONCLUSIONS
  Early rehabilitation in aSAH patients is feasible from the first day after securing the aneurysm. The rehabilitation content varied according to the patient's clinical grade. Implications for Rehabilitation Early rehabilitation is feasible from the first day after securing the ruptured aneurysm in patients with aneurysmal subarachnoid hemorrhage (aSAH). Early rehabilitation requires close monitoring and continuous adjustment for the content and amount according to the patient's clinical condition. Interdisciplinary collaboration is recommended to match the rehabilitation needs to the medical condition on a daily basis.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Oslo University Hospital , Ullevaal, Nydalen, Oslo , Norway .
authors.forename: Tanja
authors.initials: T
authors.lastname: Karic
authors.forename: Angelika
authors.initials: A
authors.lastname: Sorteberg
authors.forename: Tonje
authors.initials: T
authors.lastname: Haug Nordenmark
authors.forename: Frank
authors.initials: F
authors.lastname: Becker
authors.forename: Cecilie
authors.initials: C
authors.lastname: Roe
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000534:rehabilitation*; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: Brain injury; early rehabilitation; intracranial aneurysm; mobilization; stroke; subarachnoid hemorrhage