{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:00:21Z","timestamp":1792555221012,"version":"4.5.0"},"reference-count":96,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Intensive Care Unit-Acquired Weakness (ICUAW) is a very common condition in patients admitted to intensive care units (ICUs), even after relatively short stays. This weakness can develop with a pre-existing background of sarcopenia or cachexia, although these conditions are not always the direct cause. Over the years, much of the literature has focused on the nutritional aspect of the issue, leading to the development of widely accepted guidelines recommending the initiation of early nutrition, with the goal of achieving caloric and protein targets within the first five days of ICU admission. Despite adherence to these guidelines, several studies have shown a significant loss of muscle mass in critically ill patients, which directly impacts their ability to generate strength. However, it has become increasingly evident that nutrition alone is not sufficient to counteract this muscle loss, which is often closely linked to the prolonged immobility experienced by ICU patients due to a variety of clinical and logistical factors. In particular, there is growing evidence suggesting that even the introduction of early and minimal rehabilitation\u2014including passive mobilization\u2014when combined with appropriate nutritional support, can be a valuable strategy to help reduce the incidence of ICUAW. In this narrative review, we aim to summarize the current scientific knowledge on this topic, emphasizing the importance of an integrated approach that combines nutrition and early mobilization. Such a combined strategy not only holds the potential to reduce the acute incidence of ICUAW but also contributes to better recovery outcomes and, eventually, improved quality of life for these patients.<\/jats:p>","DOI":"10.3390\/nu17061073","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T07:48:37Z","timestamp":1742370517000},"page":"1073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Combined Effects of Early Mobilization and Nutrition on ICU-Acquired Weakness"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-7480","authenticated-orcid":false,"given":"Paolo","family":"Formenti","sequence":"first","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milan, Ospedale Bassini, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5724-9741","authenticated-orcid":false,"given":"Alessandro","family":"Menozzi","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Sabbatini","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milan, Ospedale Bassini, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Gotti","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milan, Ospedale Bassini, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Galimberti","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milan, Ospedale Bassini, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Bruno","sequence":"additional","affiliation":[{"name":"School of Medicine and Surgery, University of Milan, 20121 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9130-5554","authenticated-orcid":false,"given":"Angelo","family":"Pezzi","sequence":"additional","affiliation":[{"name":"SC Anestesia, Rianimazione e Terapia Intensiva, ASST Nord Milan, Ospedale Bassini, 20097 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4356-3543","authenticated-orcid":false,"given":"Michele","family":"Umbrello","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, New Hospital of Legnano, 20025 Legnano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lad, H., Saumur, T.M., Herridge, M.S., Dos Santos, C.C., Mathur, S., Batt, J., and Gilbert, P.M. (2020). Intensive Care Unit-Acquired Weakness: Not Just Another Muscle Atrophying Condition. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21217840"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/ane.12964","article-title":"Risk Factors for Intensive Care Unit-Acquired Weakness: A Systematic Review and Meta-Analysis","volume":"138","author":"Yang","year":"2018","journal-title":"Acta Neurol. Scand."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1164\/rccm.201312-2257OC","article-title":"Acute Outcomes and 1-Year Mortality of Intensive Care Unit-Acquired Weakness. A Cohort Study and Propensity-Matched Analysis","volume":"190","author":"Hermans","year":"2014","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s13054-020-2807-9","article-title":"Role of ICU-Acquired Weakness on Extubation Outcome among Patients at High Risk of Reintubation","volume":"24","author":"Thille","year":"2020","journal-title":"Crit. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European Consensus on Definition and Diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1002\/jcsm.12383","article-title":"GLIM Criteria for the Diagnosis of Malnutrition\u2014A Consensus Report from the Global Clinical Nutrition Community","volume":"10","author":"Cederholm","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1152\/physrev.00061.2017","article-title":"Sarcopenia: Aging-Related Loss of Muscle Mass and Function","volume":"99","author":"Larsson","year":"2019","journal-title":"Physiol. Rev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1016\/j.jamda.2020.03.006","article-title":"Frailty, Sarcopenia, and Malnutrition Frequently (Co-)Occur in Hospitalized Older Adults: A Systematic Review and Meta-Analysis","volume":"21","author":"Luiking","year":"2020","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2244","DOI":"10.1016\/j.clnu.2022.07.041","article-title":"Advances in Muscle Health and Nutrition: A Toolkit for Healthcare Professionals","volume":"41","author":"Prado","year":"2022","journal-title":"Clin. Nutr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1183\/09031936.00094411","article-title":"Rehabilitation, Weaning and Physical Therapy Strategies in Chronic Critically Ill Patients","volume":"39","author":"Ambrosino","year":"2012","journal-title":"Eur. Respir. J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1515\/jtim-2016-0016","article-title":"Post-Intensive Care Syndrome: An Overview","volume":"5","author":"Rawal","year":"2017","journal-title":"J. Transl. Int. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1016\/j.clnu.2023.07.011","article-title":"ESPEN Practical and Partially Revised Guideline: Clinical Nutrition in the Intensive Care Unit","volume":"42","author":"Singer","year":"2023","journal-title":"Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Keller, U. (2019). Nutritional Laboratory Markers in Malnutrition. J. Clin. Med., 8.","DOI":"10.3390\/jcm8060775"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Pereira, S.L., Luo, M., and Matheson, E.M. (2017). Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis. Nutrients, 9.","DOI":"10.3390\/nu9080829"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1097\/MCC.0000000000000844","article-title":"Indirect Calorimetry In Critical Illness: A New Standard of Care?","volume":"27","author":"Jonckheer","year":"2021","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s13054-022-04000-5","article-title":"Routine Use of Indirect Calorimetry in Critically Ill Patients: Pros and Cons","volume":"26","year":"2022","journal-title":"Crit. Care"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.clnu.2018.08.037","article-title":"ESPEN Guideline on Clinical Nutrition in the Intensive Care Unit","volume":"38","author":"Singer","year":"2019","journal-title":"Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"D\u00edaz Chavarro, B.C., Molina-Recio, G., Assis Reveiz, J.K., and Romero-Salda\u00f1a, M. (2024). Factors Associated with Nutritional Risk Assessment in Critically Ill Patients Using the Malnutrition Universal Screening Tool (MUST). J. Clin. Med., 13.","DOI":"10.3390\/jcm13051236"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1002\/ncp.10419","article-title":"Nutrition Risk Screening in Intensive Care Units: Agreement Between NUTRIC and NRS 2002 Tools","volume":"35","author":"Coruja","year":"2020","journal-title":"Nutr. Clin. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yildirim, M., Yildirim, Z.S., and Deniz, M. (2024). Effect of the Modified NUTRIC Score in Predicting the Prognosis of Patients Admitted to Intensive Care Units. BMC Anesthesiol., 24.","DOI":"10.1186\/s12871-024-02866-2"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"We\u0142na, M., Adamik, B., K\u00fcbler, A., and Go\u017adzik, W. (2023). The NUTRIC Score as a Tool to Predict Mortality and Increased Resource Utilization in Intensive Care Patients with Sepsis. Nutrients, 15.","DOI":"10.3390\/nu15071648"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Mahmoodpoor, A., Sanaie, S., Sarfaraz, T., Shadvar, K., Fattahi, V., Hamishekar, H., Vahedian-Azimi, A., Samim, A., and Rahimi-Bashar, F. (2023). Prognostic Values of Modified NUTRIC Score to Assess Outcomes in Critically Ill Patients Admitted to the Intensive Care Units: Prospective Observational Study. BMC Anesthesiol., 23.","DOI":"10.1186\/s12871-023-02086-0"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1002\/jpen.2569","article-title":"Derivation of the Screening of Nutritional Risk in Intensive Care Risk Prediction Score: A Secondary Analysis of a Prospective Cohort Study","volume":"48","author":"Razzera","year":"2024","journal-title":"JPEN J. Parenter. Enteral Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.cnp.2024.08.002","article-title":"Diagnosis of \u201cIntensive Care Unit-Acquired Weakness\u201d and \u201cCritical Illness Myopathy\u201d: Do the Diagnostic Criteria Need to Be Revised?","volume":"9","author":"Rodriguez","year":"2024","journal-title":"Clin. Neurophysiol. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2298","DOI":"10.1002\/jcsm.13041","article-title":"The Current Use of Ultrasound to Measure Skeletal Muscle and Its Ability to Predict Clinical Outcomes: A Systematic Review","volume":"13","author":"Casey","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s13613-019-0531-x","article-title":"Clinical Review: Peripheral Muscular Ultrasound in the ICU","volume":"9","author":"Formenti","year":"2019","journal-title":"Ann. Intensive Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1186\/s13613-024-01395-y","article-title":"Methodologies and Clinical Applications of Lower Limb Muscle Ultrasound in Critically Ill Patients: A Systematic Review and Meta-Analysis","volume":"14","author":"Venco","year":"2024","journal-title":"Ann. Intensive Care"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/S0140-6736(14)62000-6","article-title":"Prognostic Value of Grip Strength: Findings from the Prospective Urban Rural Epidemiology (PURE) Study","volume":"386","author":"Leong","year":"2015","journal-title":"Lancet"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"R229","DOI":"10.1186\/cc13052","article-title":"Clinical Predictive Value of Manual Muscle Strength Testing during Critical Illness: An Observational Cohort Study","volume":"17","author":"Connolly","year":"2013","journal-title":"Crit. Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.hrtlng.2019.07.001","article-title":"Use of Handgrip Dynamometry for Diagnosis and Prognosis Assessment of Intensive Care Unit Acquired Weakness: A Prospective Study","volume":"48","author":"Ravetti","year":"2019","journal-title":"Heart Lung"},{"key":"ref_32","first-page":"e57595","article-title":"Mobilizing Progress: A Comprehensive Review of the Efficacy of Early Mobilization Therapy in the Intensive Care Unit","volume":"16","author":"Singam","year":"2024","journal-title":"Cureus"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s40560-024-00724-4","article-title":"From Bedside to Recovery: Exercise Therapy for Prevention of Post-Intensive Care Syndrome","volume":"12","author":"Liu","year":"2024","journal-title":"J. Intensive Care"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1186\/cc11820","article-title":"Clinical Review: Early Patient Mobilization in the ICU","volume":"17","author":"Hodgson","year":"2013","journal-title":"Critical Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13054-022-04253-0","article-title":"The Rate and Assessment of Muscle Wasting during Critical Illness: A Systematic Review and Meta-Analysis","volume":"27","author":"Fazzini","year":"2023","journal-title":"Crit. Care"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/mus.24095","article-title":"Role of Exercise in Maintaining the Integrity of the Neuromuscular Junction","volume":"49","author":"Nishimune","year":"2014","journal-title":"Muscle Nerve"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Nishimune, H., Numata, T., Chen, J., Aoki, Y., Wang, Y., Starr, M.P., Mori, Y., and Stanford, J.A. (2012). Active Zone Protein Bassoon Co-Localizes with Presynaptic Calcium Channel, Modifies Channel Function, and Recovers from Aging Related Loss by Exercise. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0038029"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"C1149","DOI":"10.1152\/ajpcell.00487.2002","article-title":"Regulation of Neuregulin\/ErbB Signaling by Contractile Activity in Skeletal Muscle","volume":"284","author":"Lebrasseur","year":"2003","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/CCM.0000000000005285","article-title":"Physical Rehabilitation in the ICU: A Systematic Review and Meta-Analysis","volume":"50","author":"Wang","year":"2022","journal-title":"Crit. Care Med."},{"key":"ref_40","first-page":"E122","article-title":"An Abundant Supply of Amino Acids Enhances the Metabolic Effect of Exercise on Muscle Protein","volume":"273","author":"Biolo","year":"1997","journal-title":"Am. J. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/nicc.12455","article-title":"The Effect of Early Mobilization in Critically Ill Patients: A Meta-Analysis","volume":"25","author":"Zang","year":"2020","journal-title":"Nurs. Crit. Care"},{"key":"ref_42","first-page":"4118896","article-title":"Effects of the High-Intensity Early Mobilization on Long-Term Functional Status of Patients with Mechanical Ventilation in the Intensive Care Unit","volume":"2024","author":"Zhang","year":"2024","journal-title":"Crit. Care Res. Pract."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Wu, X., Li, Z., Cao, J., Jiao, J., Wang, Y., Liu, G., Liu, Y., Li, F., Song, B., and Jin, J. (2018). The Association between Major Complications of Immobility during Hospitalization and Quality of Life among Bedridden Patients: A 3 Month Prospective Multi-Center Study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0205729"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"384","DOI":"10.21037\/atm.2018.05.50","article-title":"Effects of Patient Positioning on Respiratory Mechanics in Mechanically Ventilated ICU Patients","volume":"6","author":"Mezidi","year":"2018","journal-title":"Ann. Transl. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1186\/s13054-023-04333-9","article-title":"Association of Early Mobility with the Incidence of Deep-Vein Thrombosis and Mortality among Critically Ill Patients: A Post Hoc Analysis of PREVENT Trial","volume":"27","author":"AlQahtani","year":"2023","journal-title":"Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.apmr.2008.08.212","article-title":"A Systematic Review of Therapeutic Interventions for Pressure Ulcers Following Spinal Cord Injury","volume":"90","author":"Regan","year":"2009","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1097\/DCC.0000000000000461","article-title":"Environmental Factors Affecting Early Mobilization and Physical Disability Post-Intensive Care: An Integrative Review Through the Lens of the World Health Organization International Classification of Functioning, Disability, and Health","volume":"40","author":"Potter","year":"2021","journal-title":"Dimens. Crit. Care Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/ams2.415","article-title":"Post-Intensive Care Syndrome: Its Pathophysiology, Prevention, and Future Directions","volume":"6","author":"Inoue","year":"2019","journal-title":"Acute Med. Surg."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1055\/s-0040-1710572","article-title":"Prevention and Management of Delirium in the Intensive Care Unit","volume":"42","author":"Mart","year":"2021","journal-title":"Semin. Respir. Crit. Care Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1016\/S0140-6736(09)60658-9","article-title":"Early Physical and Occupational Therapy in Mechanically Ventilated, Critically Ill Patients: A Randomised Controlled Trial","volume":"373","author":"Schweickert","year":"2009","journal-title":"Lancet"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/nicc.12134","article-title":"Complications Related to Early Mobilization of Mechanically Ventilated Patients on Intensive Care Units","volume":"21","author":"Nydahl","year":"2014","journal-title":"Nurs. Crit. Care"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/CNQ.0000000000000390","article-title":"The Effect of Early Mobilization on Respiratory Parameters of Mechanically Ventilated Patients with Respiratory Failure","volume":"45","author":"Rezvani","year":"2022","journal-title":"Crit. Care Nurs. Q."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s40560-023-00670-7","article-title":"Post-Intensive Care Syndrome (PICS): Recent Updates","volume":"11","author":"Hiser","year":"2023","journal-title":"J. Intensive Care"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"EVIDoa2200234","DOI":"10.1056\/EVIDoa2200234","article-title":"The Effect of Mobilization at 6 Months after Critical Illness\u2014Meta-Analysis","volume":"2","author":"Paton","year":"2023","journal-title":"NEJM Evid."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/S2213-2600(22)00489-1","article-title":"Effect of Early Mobilisation on Long-Term Cognitive Impairment in Critical Illness in the USA: A Randomised Controlled Trial","volume":"11","author":"Patel","year":"2023","journal-title":"Lancet Respir. Med."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Avgeri, K., Zakynthinos, E., Tsolaki, V., Sgantzos, M., Fotakopoulos, G., and Makris, D. (2023). Quality of Life and Family Support in Critically Ill Patients Following ICU Discharge. Healthcare, 11.","DOI":"10.3390\/healthcare11081106"},{"key":"ref_57","first-page":"7840743","article-title":"Effectiveness, Safety, and Barriers to Early Mobilization in the Intensive Care Unit","volume":"2020","author":"Alaparthi","year":"2020","journal-title":"Crit. Care Res. Pract."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"781","DOI":"10.4187\/respcare.10481","article-title":"Early Mobilization for Critically Ill Patients","volume":"68","author":"Yang","year":"2023","journal-title":"Respir. Care"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/CNQ.0000000000000013","article-title":"What Are the Hemodynamic and Respiratory Effects of Passive Limb Exercise for Mechanically Ventilated Patients Receiving Low-Dose Vasopressor\/Inotropic Support?","volume":"37","author":"Genc","year":"2014","journal-title":"Crit. Care Nurs. Q."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1589\/jpts.29.312","article-title":"Passive Exercise of the Lower Limbs and Trunk Alleviates Decreased Intestinal Motility in Patients in the Intensive Care Unit after Cardiovascular Surgery","volume":"29","author":"Morisawa","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e1006","DOI":"10.1097\/CCE.0000000000001006","article-title":"Passive Movements Do Not Appear to Prevent or Reduce Joint Stiffness in Medium to Long-Stay ICU Patients: A Randomized, Controlled, Within-Participant Trial","volume":"5","author":"Stiller","year":"2023","journal-title":"Crit. Care Explor."},{"key":"ref_62","first-page":"CD003585","article-title":"Occupational Therapy for Adults with Problems in Activities of Daily Living after Stroke","volume":"2017","author":"Legg","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1177\/0269215508101741","article-title":"Writing SMART Rehabilitation Goals and Achieving Goal Attainment Scaling: A Practical Guide","volume":"23","author":"Botell","year":"2009","journal-title":"Clin. Rehabil."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1186\/s13054-021-03741-z","article-title":"Ten Strategies to Optimize Early Mobilization and Rehabilitation in Intensive Care","volume":"25","author":"Hodgson","year":"2021","journal-title":"Crit. Care"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1186\/s13054-023-04539-x","article-title":"Personalized Nutrition Therapy in Critical Care: 10 Expert Recommendations","volume":"27","author":"Wischmeyer","year":"2023","journal-title":"Crit. Care"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e1121","DOI":"10.1097\/CCM.0000000000004574","article-title":"Clinical Practice Guidelines for Early Mobilization in the ICU: A Systematic Review","volume":"48","author":"Lang","year":"2020","journal-title":"Crit. Care Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e860","DOI":"10.1097\/CCM.0000000000005058","article-title":"Mobilization During Critical Illness: A Higher Level of Mobilization Improves Health Status at 6 Months, a Secondary Analysis of a Prospective Cohort Study","volume":"49","author":"Paton","year":"2021","journal-title":"Crit. Care Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.aucc.2024.06.004","article-title":"Feasibility and Safety of Interactive Virtual Reality Upper Limb Rehabilitation in Patients with Prolonged Critical Illness","volume":"37","author":"Haghedooren","year":"2024","journal-title":"Aust. Crit. Care"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e18461","DOI":"10.7717\/peerj.18461","article-title":"The Feasibility of Virtual Reality Therapy for Upper Extremity Mobilization during and after Intensive Care Unit Admission","volume":"13","author":"Beumeler","year":"2025","journal-title":"PeerJ"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.physbeh.2018.11.007","article-title":"How Fitting Is F.I.T.T.?: A Perspective on a Transition from the Sole Use of Frequency, Intensity, Time, and Type in Exercise Prescription","volume":"199","author":"Burnet","year":"2019","journal-title":"Physiol. Behav."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1097\/MOG.0000000000000047","article-title":"How Soon Should We Start Interventional Feeding in the ICU?","volume":"30","author":"Fremont","year":"2014","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"3047732","DOI":"10.1155\/2021\/3047732","article-title":"Comparison of the Initiation Time of Enteral Nutrition for Critically Ill Patients: At Admission vs. 24 to 48 Hours after Admission","volume":"2021","author":"Yu","year":"2021","journal-title":"Emerg. Med. Int."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/CCM.0000000000003152","article-title":"Early Enteral Nutrition Provided Within 24 Hours of ICU Admission: A Meta-Analysis of Randomized Controlled Trials","volume":"46","author":"Tian","year":"2018","journal-title":"Crit. Care Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s41999-019-00172-6","article-title":"How Effective Is Nutrition Education Aiming to Prevent or Treat Malnutrition in Community-Dwelling Older Adults? A Systematic Review","volume":"10","author":"Rea","year":"2019","journal-title":"Eur. Geriatr. Med."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1056\/NEJMoa1102662","article-title":"Early versus Late Parenteral Nutrition in Critically Ill Adults","volume":"365","author":"Casaer","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s13054-023-04317-9","article-title":"Toward Nutrition Improving Outcome of Critically Ill Patients: How to Interpret Recent Feeding RCTs?","volume":"27","author":"Gunst","year":"2023","journal-title":"Crit. Care"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.nut.2006.10.005","article-title":"Effect of Severe Undernutrition and Subsequent Refeeding on Gut Mucosal Protein Fractional Synthesis in Human Subjects","volume":"23","author":"Winter","year":"2007","journal-title":"Nutrition"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"8815655","DOI":"10.1155\/2020\/8815655","article-title":"Early Enteral Nutrition Preserves Intestinal Barrier Function through Reducing the Formation of Neutrophil Extracellular Traps (NETs) in Critically Ill Surgical Patients","volume":"2020","author":"Hu","year":"2020","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.clnesp.2019.12.100","article-title":"The Epidemiology of Overfeeding in Mechanically Ventilated Intensive Care Patients","volume":"36","author":"Tanaka","year":"2020","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"103771","DOI":"10.1016\/j.iccn.2024.103771","article-title":"Refeeding Syndrome in the ICU: A Serious Problem Still Lacking an Evidence-Based Approach","volume":"85","author":"Papathanakos","year":"2024","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1164\/rccm.202112-2780OC","article-title":"Muscle Protein Synthesis after Protein Administration in Critical Illness","volume":"206","author":"Chapple","year":"2022","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/S0140-6736(22)02469-2","article-title":"The Effect of Higher Protein Dosing in Critically Ill Patients with High Nutritional Risk (EFFORT Protein): An International, Multicentre, Pragmatic, Registry-Based Randomised Trial","volume":"401","author":"Heyland","year":"2023","journal-title":"Lancet"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.clnu.2005.03.006","article-title":"Negative Impact of Hypocaloric Feeding and Energy Balance on Clinical Outcome in ICU Patients","volume":"24","author":"Villet","year":"2005","journal-title":"Clin. Nutr."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1186\/s13054-022-04143-5","article-title":"The Role of Nutrition Rehabilitation in the Recovery of Survivors of Critical Illness: Underrecognized and Underappreciated","volume":"26","author":"Moisey","year":"2022","journal-title":"Crit. Care"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Zhou, W., Yu, L., Fan, Y., Shi, B., Wang, X., Chen, T., Yu, H., Liu, J., Wang, X., and Liu, C. (2022). Effect of Early Mobilization Combined with Early Nutrition on Acquired Weakness in Critically Ill Patients (EMAS): A Dual-Center, Randomized Controlled Trial. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268599"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/j.clnu.2020.07.036","article-title":"High Protein versus Medium Protein Delivery under Equal Total Energy Delivery in Critical Care: A Randomized Controlled Trial","volume":"40","author":"Nakamura","year":"2021","journal-title":"Clin. Nutr."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"de Azevedo, J.R.A., Lima, H.C.M., Frota, P.H.D.B., Nogueira, I.R.O.M., de Souza, S.C., Fernandes, E.A.A., and Cruz, A.M. (2021). High-Protein Intake and Early Exercise in Adult Intensive Care Patients: A Prospective, Randomized Controlled Trial to Evaluate the Impact on Functional Outcomes. BMC Anesthesiol., 21.","DOI":"10.1186\/s12871-021-01492-6"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.jcrc.2015.05.002","article-title":"Improving Rehabilitation after Critical Illness through Outpatient Physiotherapy Classes and Essential Amino Acid Supplement: A Randomized Controlled Trial","volume":"30","author":"Jones","year":"2015","journal-title":"J. Crit. Care"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1378\/chest.13-2046","article-title":"Impact of Early Mobilization on Glycemic Control and ICU-Acquired Weakness in Critically Ill Patients Who Are Mechanically Ventilated","volume":"146","author":"Patel","year":"2014","journal-title":"Chest"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1113\/jphysiol.2011.225003","article-title":"Muscle Protein Synthesis in Response to Nutrition and Exercise","volume":"590","author":"Atherton","year":"2012","journal-title":"J. Physiol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"740","DOI":"10.3390\/nu4070740","article-title":"Exercise and Amino Acid Anabolic Cell Signaling and the Regulation of Skeletal Muscle Mass","volume":"4","author":"Pasiakos","year":"2012","journal-title":"Nutrients"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1002\/cphy.c180020","article-title":"Mechanosensing and Mechanoregulation of Endothelial Cell Functions","volume":"9","author":"Fang","year":"2019","journal-title":"Compr. Physiol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"111797","DOI":"10.1016\/j.nut.2022.111797","article-title":"Elucidating the Underlying Mechanism of Amino Acids to Regulate Muscle Protein Synthesis: Effect on Human Health","volume":"103\u2013104","author":"Lv","year":"2022","journal-title":"Nutrition"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"e1915138","DOI":"10.1001\/jamanetworkopen.2019.15138","article-title":"Association of Nutritional Support with Clinical Outcomes Among Medical Inpatients Who Are Malnourished or at Nutritional Risk: An Updated Systematic Review and Meta-Analysis","volume":"2","author":"Gomes","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1002\/jpen.1966","article-title":"Ultrasonography and Other Nutrition Assessment Methods to Monitor the Nutrition Status of Critically Ill Patients","volume":"45","author":"Rodrigues","year":"2021","journal-title":"JPEN J. Parenter. Enteral Nutr."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.aucc.2015.05.002","article-title":"Early Rehabilitation in the Intensive Care Unit: An Integrative Literature Review","volume":"28","author":"Sosnowski","year":"2015","journal-title":"Aust. Crit. Care"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/6\/1073\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:56:31Z","timestamp":1760028991000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/6\/1073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,19]]},"references-count":96,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["nu17061073"],"URL":"https:\/\/doi.org\/10.3390\/nu17061073","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,19]]}}}