Early Mobility—Multimodal Effects on Function

Persons hospitalized with neurologic impairments may suffer long-term deleterious effects after immobility, with sequelae affecting the neuromusculoskeletal system, lungs, heart, and digestive system, and combining to cause orthostatic dysfunction. Immobility harm contributes to hospital-acquired physical impairments associated with increased hospital length of stay, hospital-acquired complications, nursing facility and acute inpatient rehabilitation admissions, and impaired physical functioning. Early mobilization has been proposed as a promising intervention to counteract debility because it attenuates critical illness-associated muscle weakness and improves function. Regardless of the different techniques used for early mobility, early mobilization may be initiated safely in the acute hospital setting for many populations and appears to improve the functional capacity and discharged-to-home rate without increasing adverse events. In the stroke, traumatic brain injury, and spinal cord injury populations, neurological impairments add to immobility harms. Thus, special attention to prolonged sedation, focal impairments, seating and positioning, severe weakness, and early therapy interventions is imperative around how to facilitate recovery and prevention.