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Systematic review
Bed rest: outdated following traumatic solid organ injury?
  1. James Ashcroft1,2 and
  2. M Khan1,2
  1. 1 Department of Surgery and Cancer, Imperial College London, London, UK
  2. 2 St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Dr James Ashcroft, Department of Surgery and Cancer, Imperial College London, London W2 1NY, UK; james.ashcroft17{at}imperial.ac.uk

Abstract

Introduction This systematic review aimed to evaluate early ambulation protocols implemented for traumatic solid organ injury.

Methods The electronic databases PubMed, Medline (Ovid), Embase and Cochrane Library were searched without time constraint to identify prospective and retrospective analyses, randomised controlled trials, cohort studies, and case series that investigated early ambulation in solid organ trauma.

Results Six studies met the predefined inclusion criteria and were reviewed. Three studies investigated early ambulation protocols in direct comparison with bed rest. The remaining three studies were early ambulation case series. In all studies there was no convincing evidence to suggest differences in clinical outcomes between early ambulation and bed rest protocols. In all studies early ambulation resulted in a reduced length of hospitalisation and decreased cost to national healthcare services.

Conclusions This systematic review has found preliminary evidence that suggests bed rest has no clinical benefit in those with low-grade to mid-grade (grades 1–2) solid organ injury. Further studies are required to inform guidance to improve trauma patient outcomes.

  • trauma management
  • rehabilitation medicine
  • interventional radiology

https://doi.org/10.1136/bmjmilitary-2019-001374

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    Footnotes

    • Contributors JA and MK designed the structure and scope of the review. JA collected the review articles. JA and MK analysed the articles. JA prepared the draft of the manuscript. JA and MK reviewed and revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.