Pediatric Intensive Care Unit Early Mobility Program: Impact on Patient Functional Status

Area of Science:

• Pediatric Intensive Care
• Rehabilitation Medicine
• Clinical Protocols

Background:

• Pediatric Intensive Care Unit (PICU) patients often undergo sedation, restraint, and bed rest, leading to negative outcomes like prolonged hospitalization and reduced functional status.
• Early mobility interventions are crucial for mitigating these adverse effects in critically ill children.

Purpose of the Study:

• To evaluate the impact of a PICU early mobility protocol on the utilization of physical, occupational, and speech therapy (PT, OT, ST) services.
• To assess the effect of the early mobility protocol on the functional status of pediatric patients post-discharge.

Main Methods:

• A comparative study analyzing data from 2019 (pre-protocol) and 2020 (post-protocol) PICU admissions.
• Bivariate and multivariate analyses were used to compare clinical characteristics, length of stay, therapy order rates, mobility activities, and functional status scores (FSSs).

Main Results:

• Patients receiving the early mobility protocol (2020) showed significantly higher rates of physical therapy orders (79% vs. 47%) compared to the pre-protocol group (2019).
• The incidence of daily bedside mobility activities was higher in the protocol group (4.88 vs. 4.1 activities).
• Functional status scores at discharge and 3 months post-discharge were similar between the pre-protocol and protocol groups.

Conclusions:

• The PICU early mobility protocol successfully increased the frequency of PT, OT, and ST orders and daily mobility activities.
• Despite increased therapy and mobility, the protocol did not demonstrate a significant reduction in functional morbidity at discharge or 3 months post-discharge.