Bed rest: outdated following traumatic solid organ injury?

Abstract

IntroductionThis systematic review aimed to evaluate early ambulation protocols implemented for traumatic solid organ injury.MethodsThe 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.ResultsSix 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.ConclusionsThis 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.