According to writer Gretchen Cuda Kroen, when Kate Klein began working as a nurse in the Cleveland Clinic’s Neurointensive Care Unit, one of the first things she noticed was that her patients spent a lot of time in bed. She knew patients with other injuries benefited from getting up and moving early on, and she wondered why not patients with brain injuries.
“I asked myself that question. I asked my colleagues that question,” Klein says. “Why aren’t these patients getting out of bed? Is there something unique about patients with neurological injury?”
Doctors have long encouraged their surgical patients to get out of bed as soon as it’s safe to do so. Movement increases circulation and speeds healing; it reduces swelling and minimizes the risk of blood clots.
However, that wasn’t the thinking with brain injuries, explains Edward Manno, director of the Neurointensive Care Unit at the Cleveland Clinic and one of the neurologists who works with Klein. “The predominant thinking was that rest was better suited for the brain,” Manno says.
Although plenty of research had been done on early mobilization of patients with other injuries, Klein discovered that no one had actually studied whether it was safe or beneficial for patients with brain injuries caused by seizures, stroke or head trauma to start rehabilitation right away. So she designed a study of her own.
Over the course of a year, Klein tracked more than 600 patients with brain injury, getting more than half of them up and out of bed as early as the first day they were admitted to the ICU. What she found was that getting up and moving had clear benefits. Patients who started their rehabilitation earlier spent less time in the ICU and less time in the hospital. “They have less pressure ulcers, less infections and spend less time on the ventilator if they need ventilator therapy,” says Klein. And most say they feel a lot better.
Thanks to nurses Nancy Albert, Kate Klein and Nancy Kaser who collaborated on a study of early mobility for patients with brain injuries; Gretchen Cuda Kroen for writing the article that caught my attention; Dustin Franz for taking the picture I used; NPR for committing its resources to the article; Google for helping me find the article; and all the other people who, directly or indirectly, made it possible for me to include the picture and text in this post.