Progressive mobility is a series of planned movements and exercises to help prevent problems while you’re in the hospital and help you get back to your normal activities.

When you’re recovering from an illness, an injury, or surgery, you might spend a lot of time lying in bed. You might not be doing daily activities like getting dressed, walking around, or sitting in a chair to eat. This means that you’re not using your muscles as much as you normally would. This lack of movement causes your muscles to become weak. So it may be harder to do your normal activities once you leave the hospital.

Bed rest and lack of movement can also cause other problems, like:

• Blood clots.
• Pneumonia (an infection in your lungs).
• Constipation (not being able to have a bowel movement).
• Falls and problems with balance.
• A pressure injury to the skin on the back of your head, buttocks, heels, or other parts of your body. This can happen when you’re lying in the same position for too long without moving.
• Depression.

Progressive mobility can help prevent those problems. It can even help you recover and leave the hospital sooner.

Progressive mobility is divided into levels. Each level includes a set of exercises and movements to help you keep and build your strength. To start, a doctor or nurse will check your current mobility level and your vital signs to see what you can do safely. If your muscles are very weak, you may start with small movements at level 1 and work your way up.

The levels will vary from hospital to hospital. They may also look different depending on what condition you are being treated for.

At the lowest level, a nurse, physical therapist, or other health professional will help you change your position in bed, move your arms and legs, and take part in your personal care (like using the bedpan). Try to keep the head of your bed up as much as possible instead of lying flat.

Even at this level, you may be able to do exercises to build your muscles. These exercises include ankle pumps, knee and elbow bends, and ceiling punches.

At this level, you’ll be helped to sit up more to build your core strength (the muscles in your belly and back that help you stay upright).

Continue to practice moving your arms and legs. Try doing simple activities, like brushing your teeth and eating without help. Keep doing the exercises from level 1 to build up your muscles.

At this level, your physical therapist may have you practice standing up and moving from your bed to a chair.

You can now do exercises while sitting in a chair. These exercises include air boxing, arm lifts, knee straightening, and seated marching.

Now you may be ready to practice walking short distances with help. For example, you may be able to go from your bed to the bathroom or hallway. You should always have a nurse or other helper to support you. You can also use a walker or other mobility aid.

Exercises at this level include marching in place, sit-to-stands, arm lifts, and air punches while standing up.

At this level you’ll do as many of your regular activities on your own as possible, but with supervision. These activities include bathing, getting dressed, and eating meals sitting in a chair.

Your physical therapist will have you practice walking longer distances and building endurance. Continue your muscle strengthening exercises from level 4.