{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T01:58:25Z","timestamp":1785376705549,"version":"3.55.0"},"reference-count":59,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF21OC0072048"],"award-info":[{"award-number":["NNF21OC0072048"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Because critical illness, sedation, and ICU treatment commonly disrupt attention, memory, and executive function, early cognitive rehabilitation during the ICU stay may preserve or restore these capacities, reduce the delirium burden, and support engagement and recovery. Our primary aim was to identify and describe cognitive rehabilitation interventions delivered during the ICU stay and describe the healthcare professionals providing them. Secondarily, we summarized patient\u2010important outcomes associated with these interventions and appraised study quality to inform future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We performed a systematic integrative review with searches in Medline, EMBASE, CINAHL, and CENTRAL. Eligible studies included adult ICU patients receiving or healthcare professionals delivering early cognitive rehabilitation initiated in the ICU. Data synthesis followed PRISMA guidelines, and risk of bias was assessed using RoB2 and ROBINS\u2010I and narratively described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 27 studies: 10 randomized clinical trials, six cross\u2010sectional studies, five cohort studies, three qualitative studies, three non\u2010randomized trials, and one mixed\u2010methods study. Four categories of interventions were identified: (1) orientation and multisensory stimulation, (2) activities of daily living (ADL)\u2010focused functional occupational therapy, (3) early mobilization and physical rehabilitation, and (4) technology\u2010based sensory and affective stimulation (music or virtual reality). Interventions were provided by nurses, physiotherapists, occupational therapists, research staff, and family members. Multi\u2010component programs combining cognitive and physical elements indicated possible benefits for selected cognitive measures. Effects estimates on delirium and ADL were inconsistent and, in several studies, were based on secondary or exploratory outcomes analyses. Outcomes related to ventilator\u2010free days, health\u2010related quality of life, and survival were also inconsistent, with substantial heterogeneity in outcome definitions, measurement tools, and assessment time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multi\u2010component cognitive rehabilitation appeared clinically applicable, but effects on patient\u2010important outcomes were uncertain. High\u2010quality research is needed to assess whether interventions targeting the improvement of cognitive function benefit ICU patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>This systematic review presents and update of published work on cognitive rehabilitation performed during ICU care and then also with assessments after critical illness in ICU survivors. The findings support the idea that this field need more robust clinical research to assess these different interventions in the ICU and their possible benefit and cost.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70240","type":"journal-article","created":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:44:58Z","timestamp":1777077898000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive Rehabilitation Interventions in the Intensive Care Unit: A Systematic Integrative Review"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6063-0753","authenticated-orcid":false,"given":"Kamila C.","family":"Lassen","sequence":"first","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6709-8055","authenticated-orcid":false,"given":"Eva","family":"Laerkner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Intensive Care Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0021-6242","authenticated-orcid":false,"given":"Janet F.","family":"Jensen","sequence":"additional","affiliation":[{"name":"Department of Neurology Zealand University Hospital Roskilde and University of Southern Denmark  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9576-4390","authenticated-orcid":false,"given":"Ingrid","family":"Egerod","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1114-7465","authenticated-orcid":false,"given":"Jan","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy and Physiotherapy Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1395-5143","authenticated-orcid":false,"given":"Kasper","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Danish Dementia Research Centre Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2948-3643","authenticated-orcid":false,"given":"Rikke S.","family":"Kj\u00e6rgaard","sequence":"additional","affiliation":[{"name":"Intensive Care Survivor CEO Science Club Denmark  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2246-731X","authenticated-orcid":false,"given":"Sepideh","family":"Olausson","sequence":"additional","affiliation":[{"name":"Institution of Health Care Sciences, Sahlgrenska Academy University of Gothenburg and Sahlgrenska University Hospital, Division for Intensive and Critical  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2979-6773","authenticated-orcid":false,"given":"Hilde","family":"W\u00f8ien","sequence":"additional","affiliation":[{"name":"Division of Emergencies and Critical Care Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8955-9374","authenticated-orcid":false,"given":"Anne H.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care G\u00f8dstrup Hospital  G\u00f8dstrup Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6536-0504","authenticated-orcid":false,"given":"Maj\u2010Brit N.","family":"Kj\u00e6r","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Copenhagen University Hospital \u2013 Rigshospitalet  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6875-1369","authenticated-orcid":false,"given":"Camilla R. 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