Cerebrovascular and systemic haemodynamic parameters during passive exercise

Abstract

Passive range of motion exercises (PROM) are often used in immobilized patients but are scarcely investigated. The aim of this study was therefore to investigate the safety of PROM with respect to intracranial, cerebrovascular and systemic haemodynamic parameters in critically ill patients at a neurosurgical intensive care unit (NICU). Twelve consecutively enrolled NICU patients underwent monitoring of their intracranial (ICP) and systemic blood pressures (BP), heart rate, cerebral blood flow velocities (CBFV) and pulsatility index (PI) during PROM treatment. Cerebral perfusion pressure (CPP) was calculated. For comparison, 12 healthy age- and gender-matched controls underwent similar testing except for ICP and CPP assessments. Patients had a lower ICP after PROM (p=0.006) but unaffected BP. Control subjects had lower BP during and after PROM (p=0.01). CBFV data and PI remained unchanged during PROM in both patients and controls, but with a significantly higher PI in the patient group than the controls. PROM can safely be used in critically ill NICU patients.

Key words::

• Brain injury
• cerebrovascular circulation
• intensive care
• passive range of motion
• physiotherapy

Acknowledgements

This study was supported by grants from the Research and Development Council of Göteborg and Bohuslän.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.