3 Key Areas for Early Pediatric Patient Mobility
Much has been published in support of the benefits of early mobility for adults. With children, the culture of the hospital really impacts how much early mobility is prioritized. A pediatric study reported that early mobility was more strongly supported in older pediatric patients and other studies support that increasing age is an independent predictor of early mobility.
But it is important to acknowledge that early mobility benefits young children and their developmental stages, as summarized in the article “Building a culture of early mobilization in the pediatric intensive care unit - a nuts and bolts approach”:
"One of the main goals of EM is to facilitate independent function. In young children, the main functional activity of daily living is play, with the type of play changing as the child grows older and develops physically and neurocognitively. Play is essential for the development of physical motor, communication, and problem-solving skills, as well as facilitating emotional resilience and creativity, and importantly is also simply enjoyable. Children with life-threatening conditions are often unable to spontaneously engage in play, and this may have a long-term impact on function, including the acquisition of normal neurodevelopmental milestones.”
According to St. Jude Hospital, the benefits of early mobility for young children include:
Restoring and maintaining physical strength.
Encouraging social and emotional well-being.
Improving sleep.
Maintaining comfort and pain control with fewer medicines.
Reducing the risk of falls.
Increasing alertness and improving attention.
Given these benefits, and what is often cited in the literature, there are three key areas for early pediatric mobility:
Post-procedural recovery - Whether same day release or overnight stay, mobility is important to reduce risk of infection, falls, pneumonia and other complications. And with more and more procedures requiring patients to recover at home, it becomes more critical that patients are moving early and often during recovery.
Long stays (oncology, cardiology) - The longer a patient stays in the hospital, the more risks and complications they face. And for patients with isolation protocols, mobility can feel like an impossibility given the size of inpatient rooms. But long stays and long recovery periods can be addressed creatively. One of our NIH-backed studies is looking at how increased ambulation for post-surgical cancer patients can reduce risk of opioid use disorder while increasing quality of life.
ICU/Critical Care - There is a lot of literature out there on ICU/CCU early mobility programs. We love the St. Jude’s BRAVE program that was launched in 2019. BRAVE (Beginning Restorative Activities Very Early) mobility program helps critically ill patients return to normal activities as soon as possible.
Mobility in pediatrics has proven beneficial and safe with the correct safety protocols in place and the participation of multidisciplinary teams. With more and more hospitals launching these programs and more tools available to support these programs, we are hoping to see a positive change in pediatrics with the implementation of early mobility protocols more broadly.
Check out ARISE as a tool for early and sustained mobility.