Early Mobilization in Critically Ill Children

Choong, Karen; Koo, Karen K. Y.; Clark, Heather; Chu, Rong; Thabane, Lehana; Burns, Karen E. A.; Cook, Deborah J.; Herridge, Margaret S.; Meade, Maureen O.

doi:10.1097/ccm.0b013e318287f592

Cited by 67 publications

(107 citation statements)

References 21 publications

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“…Not surprisingly, the majority of early mobilization research has focused on active, rather than passive, therapies. Among critically ill children, rehabilitation is primarily focused on nonmobility interventions, most commonly chest physiotherapy, and only 9.5% receive early mobilization [42,43].…”

Section: Early Mobilization In Critically Ill Patientsmentioning

confidence: 99%

“…Older children are more likely to receive early mobilization [43]. The authors postulated that this may be due to the perception of greater safety and superior cognitive and functional maturity in older children.…”

Section: Pediatric Mobilizationmentioning

confidence: 99%

“…Patients with high illness severity, coma, and/or delirium are particularly vulnerable; and the utmost care must be undertaken during exercise interventions [75]. A survey of Canadian PICU practices found that medical instability, risk of device and/or catheter dislodgement, and mechanical ventilation are perceived barriers to mobilization [43]. Despite literature that demonstrates the safety of early mobilization in high-acuity patients, physicians are reluctant to integrate mobilization into their practices [34,38,75].…”

Section: Restrictive Parameters and Contraindicationsmentioning

confidence: 99%

See 2 more Smart Citations

Early mobilization in the critical care unit: A review of adult and pediatric literature

Cameron¹,

Ball²,

Cepinskas³

et al. 2015

Journal of Critical Care

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Section: Early Mobilization In Critically Ill Patientsmentioning

confidence: 99%

Section: Pediatric Mobilizationmentioning

confidence: 99%

Section: Restrictive Parameters and Contraindicationsmentioning

confidence: 99%

See 1 more Smart Citation

Early mobilization in the critical care unit: A review of adult and pediatric literature

Cameron¹,

Ball²,

Cepinskas³

et al. 2015

Journal of Critical Care

Self Cite

229

179

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“…Rehabilitation methods and necessary resources to enhance recovery in critically ill children are currently poorly understood (9). There are numerous perceived barriers and diverse opinions regarding the appropriateness of rehabilitation in the PCCU setting (10). The primary objectives of this multicenter observational study were to evaluate acute rehabilitation practices in tertiary care PCCUs across Canada, the frequency of early mobilization, and barriers to mobilization in this population.…”

mentioning

confidence: 99%

Acute Rehabilitation Practices in Critically Ill Children

Choong

Foster

Fraser

et al. 2014

Pediatric Critical Care Medicine

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Only half of the children receive rehabilitation while in the pediatric critical care unit, and when it occurs, therapy is primarily focused on respiratory function. Mobilization appears to be reserved for at-risk children who were muscle relaxed and sedated; however, its implementation in these patients is delayed. Future pediatric-specific research is essential to identify patients at risk and to understand treatment priorities and rehabilitation strategies to improve functional recovery in critically ill children.

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“…Metade das crianças internadas não recebe fisioterapia motora durante a internação, pois os profissionais priorizam a assistência respiratória 11 Para avaliar a flexibilidade foi realizada goniometria seguindo as recomendações do Manual de Goniometria, utilizando goniômetros da marca Carci® sendo realizada por examinador treinado previamente para o procedimento. Foram mensuradas as amplitudes de movimento de flexão dos cotovelos, extensão dos joelhos e dorsiflexão dos tornozelos 12 .…”

Section: Introductionunclassified

Efeito e segurança da mobilização funcional em crianças com Síndrome de Werdnig-Hoffman

et al. 2015

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relato de caso RESUMO Objetivo. Investigar os efeitos e a segurança da mobilização funcional para ganho de flexibilidade em crianças com Síndrome de Werdnig--Hoffman ventiladas cronicamente. Método. Este trabalho é um relato de casos. Trata-se de crianças com diagnóstico de Síndrome de Werdnig-Hoffman, internadas em UTI Pediátrica, utilizando ventilação mecânica invasiva sob traqueostomia. As crianças foram submetidas ao protocolo de mobilização funcional por oito semanas, durante 30 minutos, cinco vezes por semana, baseado no método de neurodesenvolvimento. A flexibilidade foi avaliada semanalmente por meio de medidas goniométricas para flexão dos cotovelos, extensão dos joelhos e dorsiflexão dos tornozelos. A segurança da mobilização foi avaliada antes durante e após o procedimento através das medidas da frequência cardíaca, respiratória e a saturação de oxigênio. Resultados. Foram incluídas duas crianças com Síndrome de Werdnig Hoffman. Na avaliação inicial a criança (A) com cinco anos e a criança (B) com três anos, possuíam severa hipotonia. Durante a mobilização funcional, não foram observadas alterações nos parâmetros hemodinâ-micos e ventilatórios. As crianças apresentaram maior restrição articular em membros do lado esquerdo. Após oito semanas de mobilização funcional, observou-se ganho na amplitude de movimento articular. Conclusão. A mobilização funcional gerou efeitos positivos na flexibilidade, sem repercussões negativas em parâmetros cardiorrespiratórios. Unitermos. Atrofia Muscular Espinhal, Unidade de Terapia Intensiva, Fisioterapia, PediatriaCitação. Saquetto MB, Oliveira IKS, Ferreira JB, Oliveira CPN, Silva CMS, Gomes-Neto M. Efeito e segurança da mobilização funcional em crianças com Síndrome de Werdnig-Hoffman: relato de caso. ABSTRACTObjective. To investigate the effects and safety of functional mobilization to gain flexibility in children with Werdnig-Hoffman syndrome chronically ventilated. Method. This study is a case report. These are children with diagnosis of Werdnig-Hoffman syndrome admitted to the ICU Pediatric using invasive mechanical ventilation with tracheotomy. Children were subjected to a functional mobilization protocol for eight weeks, for 30 minutes, five times a week, based on neurodevelopmental method. Initially the flexibility was assessed by goniometric measures by bending the elbows. The safety of mobilization was assessed before, during and after the procedure by means of measurements of heart rate, respiratory and oxygen saturation. Results. We included two children with Werdnig Hoffman syndrome. In the initial evaluation child (A) at five years and the child (B) with three years possessed severe hypotonic. During functional mobilization changes in hemodynamic and ventilatory parameters were observed. Children had higher joint restriction on members of the left. After eight weeks of functional mobilization, there was a gain in joint range of motion for the child A and B for bending the elbows, knee extension and dorsiflexion of the ankle. Conclusion. Functional mobili...

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Early Mobilization in Critically Ill Children

Cited by 67 publications

References 21 publications

Early mobilization in the critical care unit: A review of adult and pediatric literature

Early mobilization in the critical care unit: A review of adult and pediatric literature

Acute Rehabilitation Practices in Critically Ill Children

Efeito e segurança da mobilização funcional em crianças com Síndrome de Werdnig-Hoffman

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