Rehabilitation through Empowering Movement

This informal CPD article Rehabilitation through Empowering Movement was provided by Mary Muir, National Clinical Consulting Manager and Mark Pinder, Caregiver Injury Reduction Lead at Arjo, who believe that empowering movement within healthcare environments is essential to providing quality of care.

Rehabilitation through Empowering Movement 

People are made to move. Satisfying this fundamental need throughout the care process not only promotes the healing, dignity and independence of patients, but also the confidence and overall well-being of healthcare professionals. As the specialists in this area, every action and decision we make is to empower movement within the care setting.

Low physical activity during hospitalisation leads to loss of muscle strength^{1 2}, functional performance³ and independence after hospital discharge⁴. Therefore promoting early mobility and rehabilitation helps people recover⁵ and where able regain their functional independence to return to their home and work life.

Patients and residents, caregivers, and facilities all benefit from improved or maintained mobility. Intensive care units witness a potential reduction in hospital-acquired conditions, with subsequent impact on reduced length of stay^{6 7}, overall cost of care⁸ and improvements in patient and caregiver satisfaction.

By placing a focus on early mobilisation and rehabilitation in a patient’s recovery pathway, the opportunity for rehabilitation and mobility is optimised⁹. We understand rehabilitation needs to be tailored to each patient, and achieving activity, weight bearing and mobility early in the patient’s ICU care pathway can prove challenging. Whether your patient is temporarily confined to bed, needs to be acclimatised to standing or is ready for sitting or walking practice.

Our early mobility and rehabilitation in ICU education module and range of equipment solutions are designed to help caregivers to achieve activity and mobility goals safely. 

The increased physical demand placed on healthcare professionals is apparent in all care environments;¹⁰ availability of appropriate equipment¹¹ and caregiver skills based on individual need can help in the rehabilitation process, supporting caregivers to achieve successful clinical outcomes.

Empowering movement through early mobilisation and rehabilitation achieves this by focusing on the impact that the health condition, developmental difficulty or disability, has on the person’s life rather than focusing on a diagnosis¹². It involves working in partnership with the person, their family, and friends so that they can maximise their physical potential, well-being and functional independence while having choice and control over their own lives.

Effective early mobilisation and rehabilitation delivers better outcomes¹³, improved quality of life¹⁴  and has the potential to reduce health inequalities through appropriate commissioning of services¹⁵  and make significant cost savings¹⁶ across the healthcare system.

Healthcare professionals play a tremendous role in restoring patients’ functional mobility and ultimately, their quality of life. The challenges they face are self-evident. However, all too often, we see care and therapy staff putting themselves at greater risk as they strive to achieve the best possible outcomes for their patients.

As patient handling and mobility experts, we work in partnership with healthcare professionals to find solutions that can help achieve therapeutic goals and activities while also reducing the risk of workplace musculoskeletal injury that can be associated with many care and therapy interventions.

We hope this article was helpful. For more information from Arjo, please visit their CPD Member Directory page. Alternatively please visit the CPD Industry Hubs for more CPD articles, courses and events relevant to your Continuing Professional Development requirements.

References

¹Shigeaki Inoue et al Post-intensive care syndrome: its pathophysiology, prevention, and future directions Acute Medicine & Surgery 2019; 6: 233–246. doi: 10.1002/ams2.415

²Puthacheary Z, Rawal J, Mcphail M, et al. Acute skeletal muscle wasting in critical illness. J Am Med Assoc. 2013; 310:1591–600

³Kress JP, Hall JB. ICU-acquired weakness and recovery from critical illness. N Engl J Med. 2014;370:1626–1635

⁴Berney S, Elliot D, Denehy L. ICU-acquired weakness – a call to arms (and legs). Crit Care Resusc. 2011; 13:3–4

⁵Hodgson, C.L., Schaller, S.J., Nydahl, P. et al. Ten strategies to optimize early mobilization and rehabilitation in intensive care. Crit Care 25, 324 (2021).

⁶Walker J et al (2018) Reducing the effects of immobility during hospital admissions. Nursing Times [online]; 114: 6, 18-20.

⁷Hunter A, Johnson L, Coustasse A. (2014) Reduction of intensive care unit length of stay: the case of early mobilization. Health Care Manag (Frederick). 2014 Apr-Jun;33(2):128-35. doi: 10.1097/HCM.0000000000000006. PMID: 24776831.

⁸Bognar et al.: (2015) Financial implications of a hospital early mobility program. Intensive Care Medicine Experimental 2015 3(Suppl 1):A758.

⁹NICE. Rehabilitation after critical illness in adults: quality standard QS158. 7 Sep 2017. www.nice.org.uk/guidance/qs158. https://www.nice.org.uk/guidance/qs158/resources/rehabilitation-after-critical-illness-in-adults-pdf-75545546693317.

¹⁰Richardson et al. Perspectives on preventing musculoskeletal injuries in nurses: A qualitative study. Nursing Open. 2019. 6;915-929

¹¹Daragh A, et al. Safe Patient Handling Equipment in Therapy Practice: Implications for Rehabilitation. The American Journal of Occupational Therapy. 2013

¹²NHS England Commissioning guidance for Rehabilitation (2016) https://www.england.nhs.uk/wp-content/uploads/2016/04/rehabilitation-comms-guid-16-17.pdf Accessed August 2022

¹³Alaparthi GK, Gatty A, Samuel SR, Amaravadi SK. Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit. Crit Care Res Pract. 2020 Nov 26;2020:7840743. doi: 10.1155/2020/7840743. PMID: 33294221; PMCID: PMC7714600.

¹⁴World Health Organisation https://www.who.int/news-room/fact-sheets/detail/rehabilitation  Accessed August 2022

¹⁵NHS England (2016) Equality and Health Analysis: Inequalities Commissioning Guidance for Rehabilitation https://www.england.nhs.uk/wp-content/uploads/2016/04/nhse-e-hi-analysis-comms-guid-rehab.pdf Accessed August 2022

¹⁶Agency for Research Healthcare and Quality 2015. Estimating the Additional Hospital Inpatient Cost and Mortality Associated With Selected Hospital-Acquired Conditions.