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conferenceseries
.com
Volume 08
Journal of Novel Physiotherapies
Rehabilitation Medicine 2018
May 18-19, 2018
May 18-19, 2018 Osaka, Japan
7
th
World Congress on
Physical Medicine and Rehabilitation
Holding back to move forward: Mobilization following posterior fossa neurosurgery
Gaspari Clara, Lafayette Sabrina, Kelly Jennifer Jaccoud and Anna Carolina
Paulo Niemeyer State Brain Institute, Brazil
T
he detrimental impact of immobility is known in the literature.There is awide variation of specific activity recommendations
and when the activity should begin. Increasingly, studies show the need for diagnosis-specific recommendations for
protocols. The posterior cranial fossa houses parts of the brain that controls respiration, cardiac cycle, consciousness and
balance. In the early post-operative (PO) period following posterior fossa neurosurgery, patients often have episodes of nausea,
vomiting, headaches and general discomfort. Due to a significant loss of cerebrospinal fluid (CSF) during this surgery, there
is a higher chance of developing these symptoms. Symptoms worsen with the upright posture. Traction and edema around
cranial nerve VIII can lead to vestibular symptoms and poor tolerance of positional changes and upright position. The act of
vomiting may increase intracranial pressure which could jeopardize hemostasis, cerebral perfusion and increase likelihood
of CSF leak. Nausea and vomiting can lead to delayed discharge, thereby increasing medical cost. We believe it is beneficial
for these patients to begin mobilization gradually. We have instituted a protocol that ensures a less aggressive mobilization
approach immediately following posterior fossa surgery. Day-1: Elevate head of bed and sit at edge of bed, as tolerated; Day-2:
Sit out of bed (OOB) and stand/walk, as tolerated. This approach to mobilization ensures that the patient tolerates PT or OOB
activities without worsening of symptoms. This structured protocol for mobilization of these patients allows for improved
tolerance of mobility and less risk for complications in the PO period.
cgaspari@gmail.comJ Nov Physiother 2018, Volume 8
DOI: 10.4172/2165-7025-C2-027