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The Effects of Physical Therapy-Directed Early Mobilization in the Pediatric Intensive Care Unit: A Systematic Review
Zoe Herwitz1, Mercedes Signorelli Flores, Kathryn C Nesbit
1Physical Therapy in Inpatient Rehabilitation Department, Primary Children's Hospital, Salt Lake City, Utah (Dr Herwitz); Physical Therapy, Acute Rehabilitation Center at Dignity Health, Arroyo Grande, California (Dr Signorelli Flores); Physical Therapy, Graduate Program in Physical Therapy, University of California San Francisco/San Francisco State University, San Francisco, California (Drs Nesbit and Allen); Physical Therapy, University of California San Francisco Medical Center, San Francisco, California (Dr Rhodes).
Purpose:
This study analyzed evidence of the impact of physical therapy-directed early mobilization (EM) on hospital and pediatric intensive care (PICU) length of stay, and mechanical ventilation days.
Methods:
PubMed and CINAHL were searched through January 2023. Studies included non-neonates through 18 years who participated in an EM program led by a physical therapist. Effect sizes and risk ratios were analyzed. Evidence quality of studies was assessed.
Results:
Six high-quality studies met the inclusion criteria. There was a statistically significant effect in the between-group analysis on hospital length of stay, PICU length of stay and mechanical ventilation days.
Conclusions:
This systematic review and meta-analysis support implementing EM in PICUs to reduce hospital and PICU length of stay, and mechanical ventilation days. This evidence can inform wider adoption of physical therapy-directed EM in PICUs to benefit infants and improve quality healthcare.
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