Barriers and Trends to Early Mobilization in Children With a Traumatic Brain Injury
Lauren Justice, Anna Niesman, Ben Reader, Sarah Eilerman, Shivam Joshi, Rajan Thakkar, Dana SchwartzObjective:
To describe early mobility (EM) metrics, including participation barriers, among children admitted to a pediatric ICU with TBI.
Design:
This retrospective cohort study included children aged 0–18 years with a TBI admitted to a single pediatric ICU from January 2022- July 2023. Demographics, injury characteristics, injury severity metrics, and occupational therapy (OT) and physical therapy (PT) data were collected for the first 14 ICU days. OT/PT session activity was categorized as high or low mobility based on level of active participation, and barriers were recorded.
Results:
Eighty children received 189 therapy sessions. Median admission GCS was 11, and 67.5% required mechanical ventilation. High mobility occurred in 53% of OT and 56.3% of PT evaluations, increasing to 69.7% and 68.3% respectively by ICU discharge date or day 14. Mechanical ventilation (
Conclusions:
In children with TBI, participation in EM is feasible, but barriers are common. Addressing modifiable barriers may improve OT and PT engagement and could positively affect clinical outcomes.