Patients with severe acquired brain injury show increased arousal in tilt-table training.

INTRODUCTION Patients with severe acquired brain injury (ABI) are often mobilised using a tilt-table. Complications such as orthostatic intolerance have been reported. The primary objective of this study was to investigate if using a tilt-table was feasible for mobilising patients with severe ABI admitted for sub-acute rehabilitation. We also investigated change in arousal, treatment duration before termination due to orthostatic reactions and change in muscle tone. MATERIAL AND METHODS A total of 16 patients with severe ABI were included. The patients were tilted head-up, and blood pressure, heart rate, breathing frequency and eye opening were recorded before and during the intervention. Furthermore, muscle tone was recorded before and after the intervention. RESULTS Fifteen of the 16 patients did not complete the 20-min. session of tilt training due to orthostatic intolerance. There was a significant increase in the proportion of time that the patients had open eyes during treatment as compared with before treatment (p < 0.01). The mean time to occurrence of symptoms at the first, second and third tilt was 244 (standard deviation (SD) = ± 234) sec., 277 (SD = ± 257) sec. and 155 (SD = ± 67) sec., respectively. CONCLUSION Patients with severe sub-acute ABI show orthostatic intolerance when mobilised on a tilt-table which results in a low mobilisation intensity. However, the patients showed a significant increase in arousal during mobilisation. FUNDING No external funding was received for this study. All resources were provided by the Department of Neurorehabilitation, Traumatic Brain Injury Unit, Glostrup University Hospital. TRIAL REGISTRATION not relevant.