{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:13:59Z","timestamp":1790723639890,"version":"4.1.0"},"reference-count":86,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Mobilization is defined as the application of assisted movement and physical therapy to hospitalized patients, including progressive exercise and ambulation programs. While early mobilization in the intensive care unit (ICU) has been shown to be a safe and effective intervention to improve patient outcomes in the general ICU cohort, there is currently limited evidence specific to patients with acute TBI. The aim of this service evaluation was to identify current mobilization activity and functional outcomes in patients admitted to the ICU at our institution following an acute TBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center retrospective service evaluation was performed for all patients, over 16\u202fyears-old, admitted to the ICU at our institution (a Level 1 major trauma center) with an acute TBI between January 2022 and November 2024. Patient demographics, ICU admission details, TBI severity (based on the Glasgow Coma Scale [GCS]) and functional outcomes were extracted. Mobilization outcomes included the timing of the commencement of mobilization (defined as sitting on the edge of the bed or better) and mobilization status, defined using the Manchester Mobility Scale (MMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The service evaluation included 353 patients, of whom 56.0% had severe TBI (GCS: 3\u20137). Mobilization was achieved in ICU for 53.0% of patients, with a further 18.1% first mobilized on a hospital ward post-ICU discharge. The first mobilization occurred at a median of 11\u202fdays (interquartile range: 6\u201318) after ICU admission. In patients surviving to ICU discharge, 28.9% had an MMS of 1 (bed-based exercises) at this time, with only 9.1% achieving an MMS of 7 (mobilizing 30 meters or more). Analysis by TBI severity found a significant decline in in-hospital mobilization rates with increasing TBI severity (90.7% vs. 58.4% for mild vs. severe TBI;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), with a corresponding increase in the time to the first mobilization (median: 6 vs. 13\u202fdays for mild vs. severe TBI;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acute TBI patients admitted to the ICU at our institution had low rates of mobilization and achieved low levels of mobility at ICU discharge. This service evaluation highlights the need for prospective studies into early mobilization practices in the neurotrauma ICU.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1694393","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T05:41:16Z","timestamp":1769406076000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Benchmarking mobilization practice and functional outcomes in traumatic brain injury patients admitted to the intensive care unit: a three-year service evaluation"],"prefix":"10.3389","volume":"17","author":[{"given":"Fiona","family":"Howroyd","sequence":"first","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]},{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medical and Health, University of Birmingham","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Hodson","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Preece","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tammy","family":"Lea","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Rooney","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hon Sing Geoffrey","family":"Wu","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]},{"name":"School of Sport, Exercise and Rehabilitation, University of Birmingham","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simran","family":"Rahania","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang Gao","family":"Smith","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]},{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medical and Health, University of Birmingham","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonny","family":"Veenith","sequence":"additional","affiliation":[{"name":"Royal Wolverhampton Hospital","place":["Wolverhampton, United Kingdom"]},{"name":"Institute of Acute Care, University of Wolverhampton and Royal Wolverhampton Hospital","place":["Wolverhampton, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niharika A.","family":"Duggal","sequence":"additional","affiliation":[{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medical and Health, University of Birmingham","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zubair","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United Kingdom"]},{"name":"Department of Inflammation and Ageing, School of Infection, Inflammation and Immunology, College of Medical and Health, University of Birmingham","place":["Birmingham, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Weblin","sequence":"additional","affiliation":[{"name":"Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust","place":["Birmingham, United 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