Corona Update: SURGE CAPACITY SOLUTIONS – The mobi is a mobile headwall (equipment consolidator) that can be set up in any space that has an electrical outlet: next to a chair, a bed, a cot in a hallway, a cafeteria, or anywhere patients need to be located. Click here for more information.

Early Patient Mobility Key Article

Early Mobility & COVID-19 | Improving Patient Outcomes

patient outcomes early mobility during COVID-19

Early Mobility & COVID-19 | Improving Patient Outcomes


COVID-19 primarily attacks the lungs, and, although the virus itself is new, doctors are relying heavily on standard respiratory treatments (including early mobility) for the alleviation of COVID-19 symptoms and improving patient outcomes (WHO 2020). In the initial surge and amid the attempts to quarantine, early mobilization of COVID-19 patients was impossible to implement, but it has long been established that early mobilization of patients with severe respiratory infections activates the body’s own defenses, shortens length of stay, and significantly improves both short-and long-term patient outcomes.

The benefits of early mobilization for improving patient outcomes has been particularly well-documented for geriatric patients, who are at highest risk from COVID-19, and pediatric patients, who represent an increasingly significant percentage of COVID-19 patients. Now that there are dedicated COVID-19 wards and facilities, mobilization within a quarantined area is increasingly feasible and offers an immediate, proven, cost-saving option for saving lives and minimizing the burden for hospital staff.

Key Facts:

  • The severity of COVID-19 is defined in the same progression as any other severe acute respiratory infection: pneumonia, severe pneumonia, acute respiratory distress syndrome (ARDS), sepsis, and septic shock. The best-practice guidelines follow standard treatments for severe respiratory illness. (WHO 2020)
  • For patients with community-acquired pneumonia, early mobilization (at least 20 minutes out of bed within 24 hours) can significantly reduce hospitalization time by an average of 1.5 days without increasing the risk of re-hospitalization. (Melgaard 2018, Pasikanti 2012)
  • Several comprehensive reviews of best-practice treatment show that patient mobilization initiated shortly after the start of mechanical ventilation reduces both the total duration of mechanical ventilation and patient length of stay in ICUs. (Lai 2017, Hashem 2016, Schmidt 2016, Hruska 2016)
  • A review of literature regarding early mobilization in pediatric ICUs reveals that early mobilization of critically ill patients is safe and widely beneficial. (Cameron 2015, Wieczorek 2015, Cuello-Garcia 2018) Early mobilization is particularly important for children because the stress of immobility combined with an unfamiliar environment, multiple caregivers, interrupted sleep, and limited environmental stimuli can cause children to regress in behavior and psychological development. (Owens 2018, Rennick 2014, Pinto, Choong 2017, Betters 2015).
  • To limit the incidence of physical, cognitive, and psychological disabilities that can result from critical illness, the Agency for Healthcare Research and Quality strongly endorses early mobilization for all patients, whenever it is feasible (AHRQ 2017) because, for critically ill patients, early mobility is the only intervention proven to result in a decrease in days of delirium. (CIBS 2000, Barr 2013, Dirkes 2019, Krupp 2019, Taito 2016, Banerjee 2011, Schweickert 2009), which is important because there is a very strong correlation between delirium, increased length of hospital stay, development of cognitive impairment, and increased chance of death in adult ICU patients. (Barr 2013)
  • When nurses and rehabilitation therapists were able to increase mobility by approximately 1 hour per ICU patient (for patients on ventilators and patients who were not), the average ICU length of stay decreased by almost 20%, floor bed average length of stay lowered by almost 40%, and twice as many patients were discharged without home services. (Corcoran 2017)



World Health Organization. Clinical management of sever acute respiratory infection (SARI) when COVID-19 disease is suspected. WHO Interim Guidance, 2020 Mar 13.

Pashikanti L, Von Ah D. Impact of early mobilization protocol on the medical-surgical inpatient population: an integrated review of literature. Clin Nurse Spec. 2012 Mar-Apr;26(2):87-94.

Melgaard D, Baandrup U, Bosted M, et al. Early mobilisation of patients with community-acquired pneumonia reduce length of hospitalization—a pilot study. J Phys Ther Sci. 2018 Jul;30(7):926-932.

Lai CC, Chou W, Chan KS, et al. Early mobilization reduces duration of mechanical ventilation and intensive care unit stay in patients with acute respiratory failure. Arch Phys Med Rehabil. 2017 May;98(5):931-939.

Hashem MD, Nelliot A, Needham DM. Early mobilization and rehabilitation in the ICU: moving back to the future. Respir Care. 2016 Jul;61(7):971-979.

Schmidt UH, Knecht L, MacIntyre NR. Should early mobilization be routine in mechanically ventilated patients? Respir Care. 2016 Jun;61(6)867-875.

Hruska P. Early mobilization of mechanically ventilated patients. Crit Care Nurs Clin North Am. 2016 Dec;28(4):412-424.

Cameron S, Ball I, Cepinskas G, et al. Early mobilization in the critical care unit: a review of adult and pediatric literature. J Crit Care. 2015 Aug;30(4):664-672.

Wieczorek B, Burke C, Al-Harbi A, Kudchdkar SR. Early mobilization in the pediatric intensive care unit: a systematic review. J Pediatr Intensive Care. 2015 Dec;4(4):212-217.

Cuello-Garcia CA, Mai SHC, Simpson R, et al. Early mobilization in critically ill children: a systematic review. J Pediatr. 2018 Dec;203:25-33.

Owens T, Tapley C. Pediatric mobility: the development of standard assessments and interventions for pediatric patients for safe patient handling and mobility. Crit Care Nurs Q. 2018;41(3):314-322.

Rennick JE, Dougherty G, Chambers C, et al. Children’s psychological and behavioral responses following pediatric intensive care unit hospitalization: the caring intensively study. BMC Pediatr. 2014;14:276.

Pinto NP, Rhinesmith EW, Kim TY, et al. Long-term function after pediatric critical illness: results from the survivor outcomes study. Pediatr Crit Care Med. 2017;18:e122-130.

Choong K, Canci F, Clark H, et al. Practice recommendations for early mobilization in critically ill children. J Pediatr Intensiv Care. 2017;7:14-26.Corcoran J, Herbsman JM, Bushnik T, et al. Early rehabilitation in the medical and surgical intensive care units for patients with and without mechanical ventilation: an interprofessional performance improvement project. PM R. 2017 Feb;9(2):113-119.

Betters KA, Hebbar KB, Farthing D, et al. Development and implementation of an early mobility program for mechanically ventilated pediatric patients. J Crit Care. 2017;41:303-308.

Hoyer EH, Brotman DJ, Chan KS, Needham DM. Barriers to early mobility of hospitalized general medicine patients: survey development and results. Am J Phys Med Rehabil. 2015;94:304-312.

Krupp A, Ehlenbach W, King B. Factors nurses in the intensive care unit consider when making decisions about patient mobility. Am J Crit Care. 2019 Jul;28(4):281-289.

Henecke L, Hessler K, LaLonde T. Inpatient ambulation: use of an ambulation platform apparatus. JONA 2015 Jun;45(6):00-00.

Nesbitt JC, Deppen S, Corcoran R, et al. Postoperative ambulation in thoracic surgery patients: standard versus modern ambulation methods. Nurs Crit Care. 2012;17(3):130-137.

Agency for Healthcare Research and Quality (AHRQ). AHRQ safety program for mechanically ventilated patients: early mobility guide for reducing ventilator-associated events in mechanically ventilated patients. AHRQ Publication. 2017 Jan;16(17)-0018-4-EF.

Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center. Early mobility and exercise. (Last accessed Jan 2020)

Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013 Jan;41(1):263-306.

Dirkes S, Kozlowski C. Early mobility in the intensive care unit: evidence, barriers, and future directions. Crit Care Nurse. 2019; 39(3):33-42.

Krupp A, Ehlenbach W, King B. Factors nurses in the intensive care unit consider when making decisions about patient mobility. Am J Crit Care. 2019 Jul;28(4):281-289.

Taito S, Shime N, Ota K, Yasuda H. Early mobilization of mechanically ventilated patients in the intensive care unit. J Intensive Care. 2016 Jul;4:50

Banerjee A, Girard T, Pandharipande P. The complex interplay between delirium, sedation, and early mobility during critical illness: applications in the trauma unit. Curr Opin Anasthesiol. 2011 Apr;24(2):195-201.

Schweickert WD, Pohlman MC, Pohlman AS, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients: a randomized controlled trial. Lancet. 2009;373(9678):1874-1882.

Letzkus I, Hengartner M, Yeago D, Crist P. The immobile pediatric population: can progressive mobility hasten recovery? J Pediatr Nurs. 2013;28(3):296-299.

Corcoran J, Herbsman JM, Bushnik T, et al. Early rehabilitation in the medical and surgical intensive care units for patients with and without mechanical ventilation: an interprofessional performance improvement project. PM R. 2017 Feb;9(2):113-119.


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What Customers Say


“6 months ago we implemented 12 mobis into our early mobility program. We have a very diverse population on our ICU and having the option of mobilizing them in a way that is helpful and assistive to staff while instilling confidence in the patient and family is great. We’re still working to figure out our ideal workflow but it’s given us concrete examples of how even our sicker vented patients can get mobilized safely and efficiently.”

Mark Rohlfing
RN, BSN Clinical Operations Manager Intensive Care Unit
Indiana University Health Ball Memorial Hospital - Muncie, IN

“After completing a research study with the LIVENGOOD mobi on our post trauma/surgical floor, I realized its potential to decrease length of stay, help with staff efficiency and empower patients to be independent.”

Lorrie Henecke
MS, APRN, ACNS-BC, CNRN Clinical Nurse Specialist
Medical Center of the Rockies, Loveland, CO

“We are so excited that the mobi helped us ambulate our very first vented patient.”

Esther Vandermeulen
University Health System - San Antonio, TX

“The LIVENGOOD mobi is very user friendly, safe and a great solution to use minimal staff and be able to contain all of the patient’s equipment.”

Michael Saccone
Saint Joseph's Hospital - Syracuse, NY

“I think the LIVENGOOD mobi will revolutionize the way we mobilize patients in the ICU. I saw patients mobilize sooner and with less anxiety with the mobi. One young patient was even able to walk outside with the mobi and her portable vent. Having the mobi made mobility a real team effort, not just a P.T. activity.”

Terra Terwilliger
PT, DPT - Adult Inpatient Physical Therapist
Rehab Services University of Minnesota Medical Center, Fairview Health System

“The LIVENGOOD platform allows my patients to be active and independent without attention being diverted to multiple lines, an oxygen tank, and other medically necessary devices. It allows patients to have hope and a sense of “normalcy”, which so often is lost after trauma or surgery.”

Jessica Gilbert
Staff Physical Therapist - Medical Center of The Rockies -Loveland, CO

“Six years ago I was introduced to the LIVENGOOD mobi. This piece of equipment has been life changing for my patients. I am now able to consolidate all of the patient’s medical devices onto an easy to push mobile platform, therefore freeing up both of my hands to safely assist my patient.”

Tanya Kensley
Poudre Valley Hospital -Fort Collins, CO

“Mobility is Life, the mobi platform will help patients move again.”

Blas Villa
University Health System - San Antonio, TX

“I was at NTI in Boston (2013) and, during the exhibit portion, I wandered across the LIVENGOOD booth. At that moment, I knew our hospital needed this mobi for our open heart recovery program. I worked with a Clinical Nurse Specialist to write a grant for this product. I am so excited to bring the mobi to our program.”

Celina Adams
John C. Lincoln - Phoenix, AZ

“We walked a vented patient with the mobi and it was awesome! This helped her physically and emotionally.”

Natalie Hariel
Tulane Medical Center - New Orleans, LA

“I am a nurse in a cardiovascular ICU… Our goal for patients is to ambulate to the chair 2 hours after extubation, often the evening of surgery day. Our patients are up and walking with central venous catheters, swan ganz catheters, chest tubes, foley catheters, and with IV medications infusing. The ambulation of these patients would not be possible without the mobi walker. Every bit of equipment that these patients need can be carried on the walker while providing the stability of a standard walker… It is an essential piece of equipment for us and we couldn’t provide the care and therapies we do without it.”

Katherine Whitfield
Athens Regional Medical Center - Athens, GA

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