Motor Recovery and Readiness for Mobilization After Spinal Anesthesia

Abstract

Background: Recovery after spinal anesthesia can be described through motor-block regression, readiness to mobilize, observed walking and discharge readiness. These outcomes need separate definitions when evidence is mapped across anesthetic studies.

Objective: To map the definitions, instruments, assessment schedules and functional criteria used to evaluate motor recovery and readiness for mobilization after spinal anesthesia in lower-limb surgery, with a focus on ambulatory care.

Methods: PubMed was searched during 12–24 September 2026 using an unchanged strategy and no search filters. The search yielded 3,729 records. Two reviewers independently screened titles and abstracts and assessed full texts, with their decisions concealed from one another until comparison. Data were extracted by one reviewer and verified by the second. Eligibility criteria were refined during screening, and earlier decisions were rechecked against the final criteria. Of 38 full-text reports assessed, 14 were included. A descriptive synthesis mapped motor recovery, mobilization and discharge separately. No prospective written protocol, registration or structured critical appraisal was used.

Results: The 14 included reports were published between 2006 and 2022; 11 concerned knee arthroscopy and three concerned other or mixed lower-limb procedures. Retrieved methods showed differences in Bromage coding, recovery thresholds, assessment frequency and timing origins. One study assessed motor function using a 1-to-6 scale, whereas others used 0-to-3 versions. Several reports distinguished motor recovery from walking; one explicitly scheduled walking attempts after sensory and motor resolution. Other reports emphasized motor recovery and discharge without establishing a separate walking assessment in the material inspected. Targeted re-examination also identified sensory-recovery criteria, sitting tolerance, sedation assessment and routine hemodynamic monitoring. One report tabulated toe-proprioception recovery with limited procedural detail. A linked protocol also included functional ambulation scoring and optional Romberg testing, without confirming which alternative was used in practice. Routine monitoring was distinguished from explicit orthostatic testing.

Conclusion: Motor recovery, readiness to mobilize, observed walking and discharge represent distinct outcomes. The included reports show substantial variation in their definitions and assessment schedules. Consequently, comparisons require attention to scale anchors, timing origins and functional criteria. The single-database search and absence of structured critical appraisal limit the breadth and strength of the conclusions.