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Three Part Question

In [adults with a calf DVT] would [anticoagulation therapy] allow [immediate mobilisation]?

Clinical Scenario

You are referred a 55 year old woman for a mobility assessment. She was diagnosed with an uncomplicated calf DVT and started anticoagulation therapy yesterday. You wonder if there is any evidence contraindicating an immediate mobility assessment.

Search Strategy

Cinhal, Medline 1996-date, Embase 1996-date, AMED, Cochrane
[{DVT OR Deep vein thrombosis} AND {anticoagulation OR warfarin OR heparin OR fragmin OR dalteparin} AND {mobility OR mobilisation OR walking OR ambulation}] LIMIT to Human and English language

Search Outcome

3 reviews and 9 papers were critiqued

Comment(s)

There were no relevant papers for this question. All papers reviewed addressed mobilty in conjunction with the use of compression stockings. None had investigated mobility in isolation. There were also no clear guidelines about how soon patients mobilised and even patients on bed rest were permitted to mobilise to the bathroom. In several of the studies patients were recruited from an outpatient population which suggests they were mobilising immediately and are not representative of our in-patient group.

Clinical Bottom Line

The majority of papers suggest that mobilisation with compression stockings did not lead to an increased risk of developing a PE. However we had not included the use of compression stockings in our clinical scenario and therefore are unable to establish whether is it safe to mobilise without these. Further research is needed to establish whether patients who have started anticoagulation therapy are able to start immediate mobilisation.