{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T16:28:26Z","timestamp":1783700906900,"version":"3.55.0"},"reference-count":40,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T00:00:00Z","timestamp":1761436800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JRM"],"abstract":"<jats:p>Background: Intensive care unit-acquired weakness (ICU-AW) affects 25\u201350% of critically ill patients, resulting in prolonged hospitalization and impaired functional recovery. Despite recognition of its clinical importance, effective prevention and treatment strategies remain limited.\nObjective: To evaluate the efficacy of a comprehensive evidence-based intervention programme on ICU-AW incidence and functional outcomes compared with standard care.\nMethods: This retrospective analysis conducted between May 2021 and December 2023 included 420 critically ill patients allocated to either an evidence-based intervention group (n\u2009=\u2009200) receiving a structured programme incorporating early mobilization, respiratory rehabilitation, swallowing training, psychological support, and nutritional optimization, or a standard care group (n\u2009=\u2009220). Primary outcomes included ICU-AW incidence and hospital length of stay. Secondary outcomes comprised MRC muscle strength scores, nutritional status (Subjective Global Assessment), and functional independence (Barthel Index).\nResults: The evidence-based intervention group demonstrated significantly lower ICU-AW incidence (32.5% vs 57.3%, p\u2009&lt;\u20090.001) and shorter hospital stays (18.4 \u00b1 6.2 days vs 25.7 \u00b1 7.8 days, p\u2009&lt;\u20090.001) compared with standard care. Post-intervention MRC scores were significantly higher in the evidence-based intervention group (50.4 \u00b1 5.9 vs 44.2 \u00b1 7.1, p\u2009&lt;\u20090.001), representing a mean improvement of 7.3 points (95% CI: 6.2\u20138.4) compared with 1.9 points (95% CI: 1.2\u20132.6) in standard care. Nutritional status improved by at least one SGA grade in 56% of evidence-based intervention patients vs 28.6% of standard care patients (p\u2009&lt;\u20090.001). Barthel Index scores increased substantially more in the evidence-based intervention group (32.3-point increase vs 13.4-point increase, p\u2009&lt;\u20090.001), with 41% achieving scores &gt;\u200975 compared with 16% in standard care (p\u2009&lt;\u20090.001).\nConclusion: A comprehensive evidence-based intervention programme significantly reduces ICU-AW incidence and improves muscle strength, nutritional status, and functional outcomes in critically ill patients. This multimodal strategy offers promise for alleviating ICU-AW\u2019s burden and warrants broader clinical adoption.<\/jats:p>","DOI":"10.2340\/jrm.v57.43563","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T06:46:59Z","timestamp":1761547619000},"page":"jrm43563","source":"Crossref","is-referenced-by-count":1,"title":["A comprehensive evidence-based intervention programme significantly reduces intensive care unit-acquired weakness and improves functional recovery: a retrospective analysis"],"prefix":"10.2340","volume":"57","author":[{"given":"Hongrui","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongxia","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,10,26]]},"reference":[{"key":"130960","doi-asserted-by":"crossref","unstructured":"Lad H, Saumur TM, Herridge MS, dos Santos CC, Mathur S, Batt J, et al. Intensive care unit-acquired weakness: not just another muscle atrophying condition. Int J Mol Sci 2020; 21: 7840.","DOI":"10.3390\/ijms21217840"},{"key":"130961","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3390\/ijms21217840","DOI":"10.3390\/ijms21217840"},{"key":"130962","unstructured":"Siao SF, Yen YH, Yu YF, Zong SL, Chen CC. [Intensive care unit-acquired weakness]. Hu Li Za Zhi 2020; 67: 6\u201313."},{"key":"130963","unstructured":"https:\/\/doi.org\/10.6224\/jn.202006_67(3).02"},{"key":"130964","doi-asserted-by":"crossref","unstructured":"Chen J, Huang M. Intensive care unit-acquired weakness: recent insights. J Intensive Med 2024; 4: 73\u201380.","DOI":"10.1016\/j.jointm.2023.07.002"},{"key":"130965","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jointm.2023.07.002.","DOI":"10.1016\/j.jointm.2023.07.002"},{"key":"130966","doi-asserted-by":"crossref","unstructured":"Teixeira JP, Mayer KP, Griffin BR, George N, Jenkins N, Pal CA, et al. Intensive care unit-acquired weakness in patients with acute kidney injury: a contemporary review. Am J Kidney Dis 2023; 81: 336\u2013351.","DOI":"10.1053\/j.ajkd.2022.08.028"},{"key":"130967","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1053\/j.ajkd.2022.08.028","DOI":"10.1053\/j.ajkd.2022.08.028"},{"key":"130968","doi-asserted-by":"crossref","unstructured":"Anekwe DE, Biswas S, Bussi\u00e8res A, Spahija J. Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis. Physiotherapy 2020; 107: 1\u201310.","DOI":"10.1016\/j.physio.2019.12.004"},{"key":"130969","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.physio.2019.12.004","DOI":"10.1016\/j.physio.2019.12.004"},{"key":"130970","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-P\u00e9rez-de-Sevilla G, S\u00e1nchez-Pinto Pinto B. Effectiveness of physical exercise and neuromuscular electrical stimulation interventions for preventing and treating intensive care unit-acquired weakness: a systematic review of randomized controlled trials. Intensive Crit Care Nurs 2023; 74: 103333.","DOI":"10.1016\/j.iccn.2022.103333"},{"key":"130971","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.iccn.2022.103333","DOI":"10.1016\/j.iccn.2022.103333"},{"key":"130972","doi-asserted-by":"crossref","unstructured":"Kim S, Kim C-G. Development and evaluation of evidence-based nursing protocol for extracorporeal membrane oxygenation to critically ill patients. J Korean Acad Nurs 2023; 53: 275.","DOI":"10.4040\/jkan.22109"},{"key":"130973","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.4040\/jkan.22109","DOI":"10.4040\/jkan.22109"},{"key":"130974","doi-asserted-by":"crossref","unstructured":"Kiper P, Rimini D, Falla D, Baba A, Rutkowski S, Maistrello L, et al. Does the score on the MRC strength scale reflect instrumented measures of maximal torque and muscle activity in post-stroke survivors? Sensors 2021; 21: 8175.","DOI":"10.3390\/s21248175"},{"key":"130975","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3390\/s21248175","DOI":"10.3390\/s21248175"},{"key":"130976","doi-asserted-by":"crossref","unstructured":"Detsky AS, McLaughlin, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? J Parenteral Enteral Nutr 1987; 11: 8\u201313.","DOI":"10.1177\/014860718701100108"},{"key":"130977","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/014860718701100108","DOI":"10.1177\/014860718701100108"},{"key":"130978","doi-asserted-by":"crossref","unstructured":"dos Reis NF, Figueiredo FCXS, Biscaro RRM, Lunardelli EB, Maurici R. Psychometric properties of the Barthel Index used at intensive care unit discharge. Am J Crit Care 2022; 31: 65\u201372.","DOI":"10.4037\/ajcc2022732"},{"key":"130979","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.4037\/ajcc2022732","DOI":"10.4037\/ajcc2022732"},{"key":"130980","doi-asserted-by":"crossref","unstructured":"Appleton RTD, Kinsella J, Quasim T. The incidence of intensive care unit-acquired weakness syndromes: a systematic review. J Intensive Care Soc 2014; 16: 126\u2013136.","DOI":"10.1177\/1751143714563016"},{"key":"130981","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1177\/1751143714563016","DOI":"10.1177\/1751143714563016"},{"key":"130982","doi-asserted-by":"crossref","unstructured":"Kanova M, Kohout P. Molecular mechanisms underlying intensive care unit-acquired weakness and sarcopenia. Int J Mol Sci2022; 23: 8396.","DOI":"10.3390\/ijms23158396"},{"key":"130983","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.3390\/ijms23158396","DOI":"10.3390\/ijms23158396"},{"key":"130984","doi-asserted-by":"crossref","unstructured":"Souron R, Morel J, Gergel\u00e9 L, Infantino P, Brownstein CG, Lapole T, et al. Relationship between intensive care unit-acquired weakness, fatigability and fatigue: What role for the central nervous system? J Crit Care 2021; 62: 101\u2013110.","DOI":"10.1016\/j.jcrc.2020.11.019"},{"key":"130985","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.jcrc.2020.11.019","DOI":"10.1016\/j.jcrc.2020.11.019"},{"key":"130986","doi-asserted-by":"crossref","unstructured":"Wolfe KS, Patel BK, MacKenzie EL, Giovanni SP, Pohlman AS, Churpek MM, et al. Impact of vasoactive medications on ICU-acquired weakness in mechanically ventilated patients. Chest 2018; 154: 781\u2013787.","DOI":"10.1016\/j.chest.2018.07.016"},{"key":"130987","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.chest.2018.07.016","DOI":"10.1016\/j.chest.2018.07.016"},{"key":"130988","doi-asserted-by":"crossref","unstructured":"TEAM Study Investigators and the ANZICS Clinical Trials Group. Early active mobilization during mechanical ventilation in the ICU. N Engl J Med 2022; 387: 1747\u20131758.","DOI":"10.1056\/NEJMoa2209083"},{"key":"130989","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1056\/nejmoa2209083","DOI":"10.1056\/NEJMoa2209083"},{"key":"130990","doi-asserted-by":"crossref","unstructured":"Eggmann S, Luder G, Verra ML, Irincheeva I, Bastiaenen CHG, Jakob SM. Functional ability and quality of life in critical illness survivors with intensive care unit acquired weakness: a secondary analysis of a randomised controlled trial. PLoS One 2020; 15: e0229725.","DOI":"10.1371\/journal.pone.0229725"},{"key":"130991","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1371\/journal.pone.0229725","DOI":"10.1371\/journal.pone.0229725"},{"key":"130992","doi-asserted-by":"crossref","unstructured":"Watanabe S, Iida Y, Ito T, Mizutani M, Morita Y, Suzuki S, et al. Effect of early rehabilitation activity time on critically ill patients with intensive care unit-acquired weakness: a Japanese retrospective multicenter study. Prog Rehabil Med 2018; 3: 20180003.","DOI":"10.2490\/prm.20180003"},{"key":"130993","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.2490\/prm.20180003","DOI":"10.2490\/prm.20180003"},{"key":"130994","doi-asserted-by":"crossref","unstructured":"Kredentser MS, Blouw M, Marten N, Sareen J, Bienvenu OJ, Ryu J, et al. Preventing posttraumatic stress in ICU survivors: a single-center pilot randomized controlled trial of ICU diaries and psychoeducation. Crit Care Med 2018; 46: 1914\u20131922.","DOI":"10.1097\/CCM.0000000000003367"},{"key":"130995","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1097\/ccm.0000000000003367","DOI":"10.1097\/CCM.0000000000003367"},{"key":"130996","doi-asserted-by":"crossref","unstructured":"Wischmeyer PE, San-Millan I. Winning the war against ICU-acquired weakness: new innovations in nutrition and exercise physiology. Crit Care 2015; 19.","DOI":"10.1186\/cc14724"},{"key":"130997","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1186\/cc14724","DOI":"10.1186\/cc14724"},{"key":"130998","doi-asserted-by":"crossref","unstructured":"Verceles AC, Serra M, Davis D, Alon G, Wells CL, Parker E, et al. Combining exercise, protein supplementation and electric stimulation to mitigate muscle wasting and improve outcomes for survivors of critical illness: the ExPrES study. Heart Lung 2023; 58: 229\u2013235.","DOI":"10.1016\/j.hrtlng.2022.11.013"},{"key":"130999","doi-asserted-by":"crossref","unstructured":"https:\/\/doi.org\/10.1016\/j.hrtlng.2022.11.013","DOI":"10.1016\/j.hrtlng.2022.11.013"}],"container-title":["Journal of Rehabilitation Medicine"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/43563\/51835","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/download\/43563\/51835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T06:47:10Z","timestamp":1761547630000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/jrm\/article\/view\/43563"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,26]]},"references-count":40,"URL":"https:\/\/doi.org\/10.2340\/jrm.v57.43563","relation":{},"ISSN":["1651-2081"],"issn-type":[{"value":"1651-2081","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,26]]}}}