Aims & Objectives: Technological and scientific advances have decreased mortality rates for critically ill children. Along with extended survival, rates of morbidity have risen, and delayed rehabilitation have been involved as contributing factor. Early mobilization (EM) may have a positive impact on prevention of morbidity in the pediatric intensive care unit (PICU). The objective of this study was to determine the prevalence of physical rehabilitation provided by physical and occupational therapists in Brazilian PICUs. Methods: We conducted a two-day point prevalence study of physical rehabilitation practices in 27 Brazil PICUs in April and June 2019. The primary outcome was therapist-provided mobility, defined as the number of patient-days with mobility provided by either a physical or occupational therapist. We also characterized barriers to mobility and potential safety events associated with mobility. Results: Data was collected for 375 patients admitted to the PICU for ≥72 hours; 60% were male and 68% were ≤ 2 years old. Two-thirds of patients days included physical-therapist provided mobility, while 4% received mobility from an occupational therapist. Nurses and family were involved in patient mobility on 58% and 42%. Mechanical ventilation was not associated with decreased therapist-provided mobility. Most common barriers to mobility were no physician order, deep sedation and cardiovascular instability. Of 1,462 documented mobilization activities, 11% were associated with a potential safety event, usually a transient change in vital signs. Conclusions: PICUs in Brazil have a high prevalence of physical-therapist provided mobility and nurse and family engagement, with a low prevalance of occupational therapy involvement in mobility.
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