Experiences of four parents with physical therapy and early mobility of their children in a pediatric critical care unit: A case series

Parisien, Rachel B.; Gillanders, Kirstie; Hennessy, Erin; Herterich, Lisa B.; Saunders, K; Lati, Jamil; Santos, Stéphanie Dos; Hassall, Alison; O’Brien, Kelly K

doi:10.3233/prm-160374

Cited by 9 publications

(20 citation statements)

References 40 publications

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“…[5][6][7] Parents have a supportive role that helps to decrease the child's anxiety, which facilitates mobility activities. 17,28 We found no significant effects on clinical outcome measures such as sedatives and opioids consumption, duration of admission and of mechanical ventilation, and prevalence of delirium. To be able to pronounce on the effect of early mobilization on clinical outcome measures, a study in a larger cohort is needed, and if possible, a randomized study design with a control group.…”

Section: Discussionmentioning

confidence: 64%

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Quality improvement intervention to stimulate early mobilisation of critically ill children

Adel

Dijk

Heer

et al. 2022

Nursing in Critical Care

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Background: Immobility during hospital stay is associated with muscle weakness, delirium, and delayed neurocognitive recovery. Early mobilization of critically ill adults improves their physical functioning and shortens the duration of mechanical ventilation. However, comparable research in children is lacking.Aims: To determine the effects of the implementation of an early mobilization (EM) program on mobility activities for critically ill children and to explore barriers and facilitators and clinical outcomes before and after implementation.Study design: A prospective single-centre before-and-after study.Methods: This study was conducted in a PICU of a large tertiary hospital. Children

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Section: Discussionmentioning

confidence: 64%

“…As identified in the PARK‐PICU USA, European, and Canadian studies, family presence and involvement are independently associated with out‐of‐bed mobility of PICU patients 5–7 . Parents have a supportive role that helps to decrease the child's anxiety, which facilitates mobility activities 17,28 …”

Section: Discussionmentioning

confidence: 97%

Quality improvement intervention to stimulate early mobilisation of critically ill children

Adel

Dijk

Heer

et al. 2022

Nursing in Critical Care

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“…It is likely these family members provided assistance to facilitation success with the mobilization procedure. Parents indeed have a uniquely supportive role during physiotherapy that clinicians cannot provide [32,33] which can help to decrease the child's anxiety and increase buy-in to participate [34]. With family visitation restrictions heightened during a global pandemic such as COVID-19, strategies are urgently needed to ensure that mobility is not negatively impacted.…”

Section: Discussionmentioning

confidence: 99%

Mobilization practices in critically ill children: a European point prevalence study (EU PARK-PICU)

et al. 2020

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Background: Early mobilization of adults receiving intensive care improves health outcomes, yet little is known about mobilization practices in paediatric intensive care units (PICUs). We aimed to determine the prevalence of and factors associated with physical rehabilitation in PICUs across Europe. Methods: A 2-day, cross-sectional, multicentre point prevalence study was conducted in May and November 2018. The primary outcome was the prevalence of physical therapy (PT)-or occupational therapy (OT)-provided mobility. Clinical data and data on patient mobility, potential mobility safety events, and mobilization barriers were prospectively collected in patients admitted for ≥72 h. Results: Data of 456 children admitted to one of 38 participating PICUs from 15 European countries were collected (456 patient days); 70% were under 3 years of age. The point prevalence of PT-and/or OT-provided mobility activities was 39% (179/456) (95% CI 34.7-43.9%) during the patient days, with significant differences between European regions. Nurses were involved in 72% (924/1283) of the mobility events; in the remaining 28%, PT/OT, physicians, family members, or other professionals were involved. Of the factors studied, family presence was most strongly positively associated with out-of-bed mobilization (aOR 7.83, 95% CI 3.09-19.79). Invasive mechanical ventilation with an endotracheal tube was negatively associated with out-of-bed mobility (aOR 0.28, 95% CI 0.12-0.68). Patients were completely immobile on 25% (115/456) of patient days. Barriers to mobilization were reported on 38% of patient days. The most common reported patient-related barriers were cardiovascular instability (n = 47, 10%), oversedation (n = 39, 9%), and medical contraindication (n = 37, 8%). Potential safety events occurred in 6% of all documented mobilization events. Conclusion: Therapists are infrequently consulted for mobilization of critically ill children in European PICUs. This study highlights the need for a systematic and interdisciplinary mobilization approach for critically ill children.

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“…Clinicians and families caring for critically ill children remain skeptical or uncomfortable about early mobilization, not only because of the implications it may have on other concurrent interventions, such as sedation, but also owing to the resources and potential workload required to mobilize a patient. 31 Second, the PICU population is heterogeneous; these children span across broad developmental and cognitive ages.…”

Section: Discussionmentioning

confidence: 99%

Early Mobilization in Critically Ill Children: A Systematic Review

Cuello-Garcia¹,

Chuen²,

Simpson³

et al. 2018

The Journal of Pediatrics

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Experiences of four parents with physical therapy and early mobility of their children in a pediatric critical care unit: A case series

Abstract: This study affords a preliminary understanding of parents' experiences with physical therapy and EM in a PCCU setting. Results provide an important foundation for future research on mobility in the context of pediatric critical care research and practice.

Cited by 9 publications

References 40 publications

Quality improvement intervention to stimulate early mobilisation of critically ill children

Quality improvement intervention to stimulate early mobilisation of critically ill children

Mobilization practices in critically ill children: a European point prevalence study (EU PARK-PICU)

Early Mobilization in Critically Ill Children: A Systematic Review

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