A REVIEW ON HOW EARLY, PROTECTED MOBILISATION OUTPERFORMS TOTAL IMMOBILISATION

Abstract

This systematic review compares early protected mobilization with total immobilization across a spectrum of musculoskeletal injuries and postoperative conditions, evaluating clinical, functional, and biological outcomes. The central hypothesis proposed that controlled early loading and movement would confer superior or equivalent healing outcomes relative to prolonged immobilization while accelerating early pain resolution and functional reintegration. Our findings consistently demonstrate that early protected mobilization performs at least as well as total immobilization for long-term healing across orthopedic and postoperative contexts, with notable early advantages. For example, in lateral ankle sprains, early mobilization significantly reduced pain at three weeks and enabled earlier return to work, with 54% of patients returning by day ten versus 13% in the immobilization group, while re-sprain rates remained identical at 8%. In simple elbow dislocation, early mobilization shortened work absenteeism and lowered total costs. Furthermore, animal model data on enthesis repair showed that seven days of immobilization followed by mobilization produced superior histological scores and load-to-failure compared to longer immobilization periods. However, benefits were conditional upon controlled loading parameters and appropriate patient selection; early mobilization did not reduce deep venous thrombosis in Achilles tendon rupture and yielded mixed results in ICU populations. Data on pain sensitization, psychological determinants, and sensorimotor control remained sparse. This review provides evidence that early protected mobilization can reshape standard rehabilitation protocols, reducing muscle atrophy, joint stiffness, and delayed functional reintegration, though further research is needed to define optimal loading parameters across specific conditions.