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Therapeutics
Review: early mobilisation is better than cast immobilisation for injured limbs

https://doi.org/10.1136/ebm.10.4.118

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    Nash CE, Mickan SM, Del Mar CB, et al. Resting injured limbs delays recovery: a systematic review. J Fam Pract 2004;53:706–12.
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 Q In patients with acute limb injuries, is early mobilisation better than rest (cast immobilisation)?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Emergency medicine ★★★★★☆☆

    METHODS

    Embedded ImageData sources:

    Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, Medline (1966–2002), EMBASE/Excerpta Medica, Web of Science, and references of retrieved studies.

    Embedded ImageStudy selection and assessment:

    randomised controlled trials (RCTs) in any language that compared early mobilisation with cast immobilisation in patients with acute limb injuries, had ⩾80% follow up, and included patients who were not predominantly young children. Quality assessment of the individual studies was based on the criteria of the Cochrane Musculoskeletal Injuries Group (maximum score 18).

    Embedded ImageOutcomes:

    patient centred outcomes (pain and swelling and satisfaction), functional outcomes (range of motion, days lost from work, and return to sport), and complications.

    MAIN RESULTS

    49 RCTs met the selection criteria. 16 trials were considered to be of …

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    Footnotes

    • For correspondence: Professor C E Del Mar, Bond University, Gold Coast, Queensland, Australia. CdelMarbond.edu.au

    • Source of funding: Australian Commonwealth Department of Health and Ageing.