Effect of passive range of motion on intracranial pressure in neurosurgical patients

Abstract

Purpose: A prospective patient study was done to evaluate the effect of passive range of motion (PROM) on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in neurosurgical patients.

Materials and methods: Twelve adult patients admitted to the neurological-neurosurgical intensive care unit of a community teaching hospital were enrolled in the study. The study patients all required ICP monitoring and they underwent a total of 20 PROM sessions. Six patients (10 PROM sessions) were mechanically ventilated, and six patients (10 PROM sessions) were breathing spontaneously. Mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), and ICP were measured at baseline and at 1-minute intervals during the physical therapy session. CPP was calculated as the difference between MAP and ICP.

Results: No significant changes were detected in MAP, ICP, HR, or RR during the study period. Calculated CPP remained unchanged. Mean duration of PROM intervention was 7 +/- 1 minute. Mean Glasgow Coma Scale (GCS) for mechanically ventilated patients was 7 +/- 1.3 and for spontaneously breathing patients 13 +/- 0.8.

Conclusion: PROM results in no significant changes in ICP or CPP in stable, neurosurgical patients in the absence of intracranial hypertension.