Four RCTs met the inclusion criteria (n=406 patients). Quality scores for the Jadad scale for the four trials ranged from 1 to 3 out of 5 points; all trials scored 7 out of 10 on the PEDro scale. Follow-up evaluations were completed from day four to 12.
There was no statistically significant difference in the pooled relative risks of the development of a pulmonary embolism for patients treated with ambulation plus compression compared with bed rest plus compression (RR 0.63, 95% CI 0.34 to 1.19; two RCTs, n=224 participants) or bed rest alone (RR 1.36, 95% CI 0.57 to 3.29; two RCTs, n=182 participants).
There was no significant difference in progression of an existing deep vein thrombus or development of a new thrombus for patients treated with ambulation plus compression compared with bed rest plus compression (RR 0.39, 95% CI 0.13 to 1.14; one RCT, n=102 participants) or bed rest alone (RR 0.56, 95% CI 0.20 to 1.57; one RCT, n=53 participants).
Two trials were stopped early due to patients or centres not wanting to use an immobilising treatment.