Neuroanesthesia & neurocritical care
Effects of early acute in-bed leg cycling initiated from the intensive care unit following severe traumatic spinal cord injury: final results from the PROMPT-SCI trial
Authors' conclusion
Early acute ABT did not increase the risk for neurological deterioration when initiated in the ICU for patients requiring hemodynamic management. It can decrease the early occurrence of spontaneous spasms, and may potentially reduce the co-occurrence of P/UTI/PI and accelerate rehabilitation transfer readiness.
Study context
- Population
- Adults with severe traumatic spinal cord injury (SCI) in the intensive care unit (ICU) for hemodynamic management
- Exposure
- Early in-bed leg cycling (activity-based therapy (ABT)) initiated in the ICU vs matched historical controls without ABT
- Outcome
- Recovery of independent walking
- Follow-up
- 6 months post-SCI
Methodological detailsmatched historical controls
- Matched historical controls
Main finding
As reported in the abstract
P = 0.3
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Estimate | P value |
|---|---|---|
| Readiness for rehabilitation transferPROMPT-SCI vs Controls · decreased, approaching statistical significance | difference 7 days | P = 0.051 |
| Readiness for rehabilitation transferPROMPT-SCI vs Controls · adjusted for baseline motor score | β −0.22 (95% CI −0.41 - −0.04) | P = 0.03 |
Neurological recovery
- Similar between the two cohorts
Safety
Spontaneous spasms
P < 10- 3
Co-occurrence of pneumonia, pressure injury and UTI (P/UTI/PI)
P = 0.03
Spontaneous spasms
- Adjusted for baseline motor score, spontaneous spasms remained decreased with ABT: OR 0.14 (95%CI: 0.04-0.45), p = 0.001
Co-occurrence of pneumonia, pressure injury and UTI (P/UTI/PI)
- Adjusted for baseline motor score, no significant association between concomitant P/UTI/PI and ABT: OR 0.14 (95%CI: 0.02-1.24), p = 0.08
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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