{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:03:43Z","timestamp":1789625023556,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>ICU-acquired weakness (ICU-AW) is a frequent complication of critical illness, and real-world evidence on nurse-led early mobilization (EM) in Asian ICUs remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a single-center, retrospective before-after cohort study of invasively ventilated adults admitted during usual-care (\n                      <jats:italic>n<\/jats:italic>\n                      = 153) and nurse-led EM (\n                      <jats:italic>n<\/jats:italic>\n                      = 164) periods. ICU-AW, defined as a Medical Research Council (MRC) sum score &amp;lt;48, was assessed among evaluable ICU survivors (\n                      <jats:italic>n<\/jats:italic>\n                      = 266); ICU death made volitional strength testing non-evaluable and was addressed in a death-or-ICU-AW composite sensitivity analysis. The primary model estimated the association between protocol implementation and ICU-AW after adjustment for baseline confounders; post-exposure care processes were examined separately.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ICU-AW occurred in 60\/129 (46.5%) usual-care survivors and 40\/137 (29.2%) nurse-led EM survivors (crude absolute risk difference 17.3 percentage points [95% CI 5.8\u201328.8] among evaluable survivors; crude OR 0.474, 95% CI 0.286\u20130.786). The baseline-adjusted OR was 0.436 (95% CI 0.248\u20130.766;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.004). Morbidity-related secondary outcomes favored nurse-led EM, including lower delirium incidence (41.2% vs. 22.6%; OR 0.416), shorter ICU stay (median 11 vs. 8 days), and higher discharge Barthel Index (70 vs. 85). No statistically significant ICU mortality difference was detected (15.7% vs. 16.5%; OR 1.059, 95% CI 0.581\u20131.93), but the study was not powered to exclude clinically important mortality effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Nurse-led EM implementation was associated with lower odds of ICU-AW and improved morbidity outcomes. Because exposure was assigned by historical period, residual and secular confounding remain important limitations, and confirmation in a randomized or stepped-wedge implementation study is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1919355","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:31:56Z","timestamp":1789623116000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nurse-led early mobilization and ICU-acquired weakness in mechanically ventilated adults: a retrospective before-after cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Haiyun","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Suzhou Wuzhong People\u2019s Hospital, Suzhou","place":["Jiangsu, 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