Clinical Question: Which is better ...

Clinical Question: Which is better for acute limb injuries, intermission or early mobilization?

Setting: Various (meta-analysis)

contemplation Design: Systematic review

Allocation: Unconcealed

Synopsis: The authors of this reflection performed a thorough search of the literature to identify all studies of quiet versus early mobilization for acute limb injuries, including fractures, strains, sprains, and other smooth tissue injuries. Included were randomized controll trials with les than 20 percent los to follow-up (or an intention-to-treat analysis), trials that studied for the greatest part adults, and those with adequate data reporting. The authors identified 187 potential articles, of which 49 met the inclusion criteria. The quality of the studies was rated upon a scale from 0 to 16; most numerous were of low quality, and the recommendations for this thought were based in large part forward the higher quality studies. The definition of early mobilization varied among studies and many times involved comparison with splinting or immobilization.

Regarding pain and swelling, 13 studies demonstrated an improvement with early mobilization and nine showed improved patient satisfaction, while no studies reported an improvement with quiescence The better quality studies base no difference or favored early mobilization. Overall function scores also were more likely to be improved by the agency of early mobilization than by quiescence and return to work was hastened in 13 of 14 studies of this issue However, patient preferences, perhaps because of their expectations, waited to favor braces or casting following acute injuries. outlay was not studied.

Bottom Line: Early mobilization following acute limb injuries generally improves function, abridges pain and swelling, and thrives return to work and sports. With accurate supervision and education, early mobilization is preferr throughout rest for an array of injuries. Unfortunately, this report does not provide highly specific guidance for mobilization of individual injuries. (Level of Evidence: 2a)

inquiry Reference: Nash CE, et al. Resting injured limbs delays recovery: a systematic review. J Fam Pract September 2004;53:706-12

Used with permission from Ebell M Early mobilization better for acute limb injuries. Accessed online November 24 2004 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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