Early Mobility in the ICU

What is early mobility?

Early mobility is a rehabilitation plan that helps your child start moving as soon as possible during their stay in the pediatric intensive care unit (PICU), also called the ICU. 

Muscles get weak when they are not used. This can slow healing and make it harder to do everyday activities like walking or using the bathroom.  

Early mobility helps your child keep their muscles strong by adding safe, gradual movement. 

Many children can do early mobility even if they need a ventilator (breathing machine) or other medical devices. Your care team helps make sure it is done safely. 

Benefits of early mobility?

Early mobility can help your child before, during, and after their stay in the ICU. It can help your child: 

• Keep their muscles strong 
• Move safely and avoid falls 
• Sleep better 
• Manage pain so they need less pain medicine 
• Stay alert and focused 
• Feel happier, calmer, and connected 
• Play and take part in activities 
• Have a lower risk for blood clots, lung problems, and delirium (feeling confused and sleepy) 

What to expect from early mobility

When your child is admitted to the ICU, their care team may include: 

• Nurses
• Respiratory therapists
• Child life specialists
• Physical therapists
• Occupational therapists
• Speech-language pathologists
• Psychologists

Your care team will assess what your child can do and what they need help with. All activities are done safely with help from the care team. 

Activities are chosen based on your child’s age, needs, and abilities.  

For most children, this program starts with moving in bed. A care team member may move your child’s arms and legs through stretching exercises. They may have your child shift from side to side or reach for things.  

As your child gets stronger, your care team will help them: 

• Sit up in bed 
• Sit on the side of the bed  
• Stand up 
• Move from the bed to a chair or wheelchair
• Walk 

Younger children often play on a soft mat. This mat is placed on the floor, next to the bed. Children lie on the mat and roll, stretch, or reach for toys. They may practice sitting or other positions. 

Early mobility goals

Your care team will work with your child to set goals for getting stronger and moving more easily.  

Goals may change as your child gets stronger or their needs change. This is normal. Progress can be slow, and it may take time to regain lost skills. Skills can be affected by being in bed for a long time or using a ventilator (breathing machine). 

Early mobility goals can include being able to: 

• Play with toys and do other age-appropriate activities 
• Build strength to sit, stand, or walk 
• Increase independence with self-care, like reaching for things, feeding themselves, or using the toilet 
• Improve communication and thinking skills 

If you have questions or concerns, talk with a member of your care team. They can explain the goals, show you how to help your child safely, and update you as your child gets stronger. 

How you can help your child with early mobility 

To help your child with early mobility in the ICU:   

• Talk with your care team about what mobility activities are safe for your child to do while in the ICU. 
• Encourage and support them as they do their mobility activities.  
• Support age-appropriate movement and play. Help with simple things like reaching for toys or moving arms and legs.  
• Let the care team know if your child gets tired, uncomfortable, or upset.  

Questions to ask your care team

• What is early mobility, and how can it help my child?  
• Is it safe for my child to start moving while in the ICU?  
• How will you decide what activities my child can do?  
• What are the goals of early mobility?  
• What activities will my child start with?  
• Can my child participate in early mobility while on a ventilator or other medical device?  
• Which care team members will help my child with early mobility?  
• How will you track my child’s progress?  

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