{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T17:20:06Z","timestamp":1783099206177,"version":"3.54.6"},"reference-count":45,"publisher":"AACN Publishing","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individual differences exist in the recovery of muscle strength in critically ill patients with intensive care unit (ICU)\u2013acquired weakness, but the characteristics of patients who do not recover muscle strength are unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To elucidate the factors associated with the nonrecovery of muscle strength in patients with ICU-acquired weakness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study involved critically ill patients with ICU\u2013acquired weakness. The patients\u2019 outcomes were categorized as recovery (Medical Research Council Sum Score [MRC-SS] \u226548 until hospital discharge or the time of stroke, death, or ICU readmission) or nonrecovery (MRC-SS &amp;lt;48). Separate logistic regression analyses adjusted for age and sex were performed for each candidate factor to identify factors associated with nonrecovery of muscle strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 111 patients were included in the analysis. Thirty patients were classified as having nonrecovery. Analysis using a logistic regression model showed that septic shock, duration of deep sedation, corticosteroid use, total amount of corticosteroids used, duration of mechanical ventilation, duration of renal replacement therapy, day of first out-of-bed mobilization, initial evaluation of MRC-SS, and length of ICU stay were age- and sex-adjusted predictors of nonrecovery of muscle strength.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with ICU\u2013acquired weakness with the predictors identified in this study may not recover muscle strength. Future multicenter interventional studies should assess not only the timing of rehabilitation but also its intensity and the muscle groups specifically targeted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ajcc2026710","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T16:43:26Z","timestamp":1783097006000},"page":"276-285","source":"Crossref","is-referenced-by-count":0,"title":["Predicting Nonrecovery of Muscle Strength in Critically Ill Patients with Intensive Care Unit\u2013Acquired Weakness"],"prefix":"10.4037","volume":"35","author":[{"given":"Hiroki","family":"Nagura","sequence":"first","affiliation":[{"name":"Hiroki Nagura is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; and Department of Rehabilitation Medicine, Nagasaki University Hospital, Nagasaki, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Oikawa","sequence":"additional","affiliation":[{"name":"Masato Oikawa is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Hanada","sequence":"additional","affiliation":[{"name":"Masatoshi Hanada is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yudai","family":"Yano","sequence":"additional","affiliation":[{"name":"Yudai Yano is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsubasa","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Tsubasa Watanabe is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutomo","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Yasutomo Tanaka is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rina","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Rina Takeuchi is a physical therapist, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuntaro","family":"Sato","sequence":"additional","affiliation":[{"name":"Shuntaro Sato is a statistician, Clinical Research Center, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohiro","family":"Sekino","sequence":"additional","affiliation":[{"name":"Motohiro Sekino is an associate professor, Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Hara","sequence":"additional","affiliation":[{"name":"Tetsuya Hara is a professor, Department of Anesthesiology and Intensive Care Medicine, Nagasaki University Graduate School of Biomedical Sciences."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Kozu","sequence":"additional","affiliation":[{"name":"Ryo Kozu is a professor, Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences; and Department of Rehabilitation Medicine, Nagasaki University Hospital."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"2","key":"2026070312431995100_b1-0350276","doi-asserted-by":"publisher","first-page":"R81","DOI":"10.1186\/cc12695","article-title":"Changes in hospital mortality for United States intensive care unit admissions from 1988 to 2012","volume":"17","author":"Zimmerman","year":"2013","journal-title":"Crit Care"},{"issue":"14","key":"2026070312431995100_b2-0350276","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1056\/NEJMoa1011802","article-title":"Functional disability 5 years after acute respiratory distress syndrome","volume":"364","author":"Herridge","year":"2011","journal-title":"N Engl J Med"},{"issue":"10 suppl","key":"2026070312431995100_b3-0350276","doi-asserted-by":"publisher","first-page":"S299","DOI":"10.1097\/CCM.0b013e3181b6ef67","article-title":"A framework for diagnosing and classifying intensive care unit-acquired weakness","volume":"37","author":"Stevens","year":"2009","journal-title":"Crit Care Med"},{"issue":"4","key":"2026070312431995100_b4-0350276","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1007\/s00134-020-05944-4","article-title":"ICU-acquired weakness","volume":"46","author":"Vanhorebeek","year":"2020","journal-title":"Intensive Care Med"},{"issue":"12","key":"2026070312431995100_b5-0350276","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1164\/rccm.201411-2011ST","article-title":"An official American Thoracic Society Clinical Practice guideline: the diagnosis of intensive care unit-acquired weakness in adults","volume":"190","author":"Fan","year":"2014","journal-title":"Am J Respir Crit Care Med"},{"issue":"5","key":"2026070312431995100_b6-0350276","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1164\/rccm.201304-0651OC","article-title":"Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding. EDEN trial follow-up","volume":"188","author":"Needham","year":"2013","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"2026070312431995100_b7-0350276","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1097\/CCM.0000000000000040","article-title":"Physical complications in acute lung injury survivors: a two-year longitudinal prospective study","volume":"42","author":"Fan","year":"2014","journal-title":"Crit Care Med"},{"issue":"1","key":"2026070312431995100_b8-0350276","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1186\/s13054-015-0979-5","article-title":"A conceptual framework: the early and late phases of skeletal muscle dysfunction in the acute respiratory distress syndrome","volume":"19","author":"Files","year":"2015","journal-title":"Crit Care"},{"key":"2026070312431995100_b9-0350276","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.physio.2019.12.004","article-title":"Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis","volume":"107","author":"Anekwe","year":"2020","journal-title":"Physiotherapy"},{"issue":"11","key":"2026070312431995100_b10-0350276","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1002\/mus.880141111","article-title":"Interobserver agreement in the assessment of muscle strength and functional abilities in Guillain-Barr\u00e9 syndrome","volume":"14","author":"Kleyweg","year":"1991","journal-title":"Muscle Nerve"},{"issue":"3","key":"2026070312431995100_b11-0350276","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/CCM.0000000000000030","article-title":"Assessment of limb muscle strength in critically ill patients: a systematic review","volume":"42","author":"Vanpee","year":"2014","journal-title":"Crit Care Med"},{"issue":"10","key":"2026070312431995100_b12-0350276","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"issue":"22","key":"2026070312431995100_b13-0350276","doi-asserted-by":"publisher","first-page":"2859","DOI":"10.1001\/jama.288.22.2859","article-title":"Paresis acquired in the intensive care unit: a prospective multicenter study","volume":"288","author":"De Jonghe","year":"2002","journal-title":"JAMA"},{"key":"2026070312431995100_b14-0350276","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/j.jcrc.2019.06.022","article-title":"Long term follow-up of quality of life and functional ability in patients with ICU acquired weakness\u2014a post hoc analysis","volume":"53","author":"Sidiras","year":"2019","journal-title":"J Crit Care"},{"issue":"3","key":"2026070312431995100_b15-0350276","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1164\/rccm.200712-1829OC","article-title":"Acquired weakness, handgrip strength, and mortality in critically ill patients","volume":"178","author":"Ali","year":"2008","journal-title":"Am J Respir Crit Care Med"},{"key":"2026070312431995100_b16-0350276","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/1471-2253-12-21","article-title":"The Functional Comorbidity Index had high inter-rater reliability in patients with acute lung injury","volume":"12","author":"Fan","year":"2012","journal-title":"BMC Anesthesiol"},{"issue":"3","key":"2026070312431995100_b17-0350276","doi-asserted-by":"publisher","first-page":"210","DOI":"10.5770\/cgj.23.463","article-title":"Using the Clinical Frailty Scale in allocating scarce health care resources","volume":"23","author":"Rockwood","year":"2020","journal-title":"Can Geriatr J"},{"issue":"7","key":"2026070312431995100_b18-0350276","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1007\/BF01709751","article-title":"The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction\/failure","volume":"22","author":"Vincent","year":"1996","journal-title":"Intensive Care Med"},{"key":"2026070312431995100_b19-0350276","first-page":"66","article-title":"Physiotherapy in the intensive care unit","volume":"15","author":"Gosselink","year":"2011","journal-title":"Neth J Crit Care"},{"issue":"1","key":"2026070312431995100_b20-0350276","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1016\/j.hrtlng.2013.11.003","article-title":"Feasibility and interrater reliability of the ICU Mobility Scale","volume":"43","author":"Hodgson","year":"2014","journal-title":"Heart Lung"},{"issue":"3","key":"2026070312431995100_b21-0350276","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1097\/CCM.0000000000002208","article-title":"Muscle weakness and 5-year survival in acute respiratory distress syndrome survivors","volume":"45","author":"Dinglas","year":"2017","journal-title":"Crit Care Med"},{"issue":"1","key":"2026070312431995100_b22-0350276","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s13054-015-0937-2","article-title":"Impact of ICU-acquired weakness on post-ICU physical functioning: a follow-up study","volume":"19","author":"Wieske","year":"2015","journal-title":"Crit Care"},{"issue":"9678","key":"2026070312431995100_b23-0350276","doi-asserted-by":"publisher","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"},{"issue":"2","key":"2026070312431995100_b24-0350276","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1007\/s13539-010-0010-6","article-title":"Intensive care unit-acquired weakness (ICUAW) and muscle wasting in critically ill patients with severe sepsis and septic shock","volume":"1","author":"Schefold","year":"2010","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"3","key":"2026070312431995100_b25-0350276","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1002\/mus.24175","article-title":"Long-term recovery in critical illness myopathy is complete, contrary to polyneuropathy","volume":"50","author":"Koch","year":"2014","journal-title":"Muscle Nerve"},{"issue":"1","key":"2026070312431995100_b26-0350276","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s13613-016-0187-8","article-title":"Assessment and predictors of physical functioning post-hospital discharge in survivors of critical illness","volume":"6","author":"Solverson","year":"2016","journal-title":"Ann Intensive Care"},{"issue":"16","key":"2026070312431995100_b27-0350276","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1001\/jama.2010.1553","article-title":"Long-term cognitive impairment and functional disability among survivors of severe sepsis","volume":"304","author":"Iwashyna","year":"2010","journal-title":"JAMA"},{"issue":"1","key":"2026070312431995100_b28-0350276","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1186\/s13054-018-2111-0","article-title":"Corticosteroid use and intensive care unit-acquired weakness: a systematic review and meta-analysis","volume":"22","author":"Yang","year":"2018","journal-title":"Crit Care"},{"issue":"2","key":"2026070312431995100_b29-0350276","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.cmet.2011.01.001","article-title":"Crosstalk between glucocorticoid receptor and nutritional sensor mTOR in skeletal muscle","volume":"13","author":"Shimizu","year":"2011","journal-title":"Cell Metab"},{"issue":"8","key":"2026070312431995100_b30-0350276","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1152\/physiolgenomics.00123.2012","article-title":"Effects of corticosteroids in the development of limb muscle weakness in a porcine intensive care unit model","volume":"45","author":"Aare","year":"2013","journal-title":"Physiol Genomics"},{"issue":"8","key":"2026070312431995100_b31-0350276","doi-asserted-by":"publisher","first-page":"1318","DOI":"10.1007\/s00134-010-1840-6","article-title":"Hormonal status and ICU-acquired paresis in critically ill patients","volume":"36","author":"Sharshar","year":"2010","journal-title":"Intensive Care Med"},{"issue":"6","key":"2026070312431995100_b32-0350276","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1111\/resp.12807","article-title":"Effect of long-term treatment with corticosteroids on skeletal muscle strength, functional exercise capacity and health status in patients with interstitial lung disease","volume":"21","author":"Hanada","year":"2016","journal-title":"Respirology"},{"issue":"2","key":"2026070312431995100_b33-0350276","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.alit.2022.10.005","article-title":"Frailty and muscle weakness in elderly patients with asthma and their association with cumulative lifetime oral corticosteroid exposure","volume":"72","author":"Ryu","year":"2023","journal-title":"Allergol Int"},{"issue":"1","key":"2026070312431995100_b34-0350276","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s13613-022-01038-0","article-title":"Chronic critical illness and post-intensive care syndrome: from pathophysiology to clinical challenges","volume":"12","author":"Voiriot","year":"2022","journal-title":"Ann Intensive Care"},{"issue":"4","key":"2026070312431995100_b35-0350276","doi-asserted-by":"publisher","first-page":"E633","DOI":"10.1210\/jc.2010-2563","article-title":"Insufficient activation of autophagy allows cellular damage to accumulate in critically ill patients","volume":"96","author":"Vanhorebeek","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"2026070312431995100_b36-0350276","doi-asserted-by":"publisher","first-page":"2176","DOI":"10.1053\/j.jvca.2023.07.032","article-title":"Mechanisms of action of the detrimental effects of propofol on survival","volume":"37","author":"Kotani","year":"2023","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"1","key":"2026070312431995100_b37-0350276","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1186\/s13054-025-05462-z","article-title":"Muscle weakness after critical illness: unravelling biological mechanisms and clinical hurdles","volume":"29","author":"Pierre","year":"2025","journal-title":"Crit Care"},{"key":"2026070312431995100_b38-0350276","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s13728-015-0036-7","article-title":"The impact of extended bed rest on the musculoskeletal system in the critical care environment","volume":"4","author":"Parry","year":"2015","journal-title":"Extrem Physiol Med"},{"issue":"3","key":"2026070312431995100_b39-0350276","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1097\/NCI.0b013e3181ac838d","article-title":"Bed rest in health and critical illness: a body systems approach","volume":"20","author":"Winkelman","year":"2009","journal-title":"AACN Adv Crit Care"},{"issue":"4","key":"2026070312431995100_b40-0350276","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1186\/cc7885","article-title":"Bench-to-bedside review: mobilizing patients in the intensive care unit\u2014from pathophysiology to clinical trials","volume":"13","author":"Truong","year":"2009","journal-title":"Crit Care"},{"issue":"12","key":"2026070312431995100_b41-0350276","doi-asserted-by":"publisher","first-page":"1828","DOI":"10.1097\/CCM.0000000000006404","article-title":"Inability to sit-to-stand in medical ICUs survivors: when and why we should care","volume":"52","author":"Siao","year":"2024","journal-title":"Crit Care Med"},{"key":"2026070312431995100_b42-0350276","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.jcrc.2018.04.003","article-title":"Quantitative peripheral muscle ultrasound in sepsis: muscle area superior to thickness","volume":"47","author":"Palakshappa","year":"2018","journal-title":"J Crit Care"},{"issue":"1","key":"2026070312431995100_b43-0350276","doi-asserted-by":"publisher","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":"2026070312431995100_b44-0350276","doi-asserted-by":"publisher","first-page":"622823","DOI":"10.3389\/fnut.2021.622823","article-title":"Ultrasound for non-invasive assessment and monitoring of quadriceps muscle thickness in critically ill patients with acute kidney injury","volume":"8","author":"Sabatino","year":"2021","journal-title":"Front Nutr"},{"issue":"7","key":"2026070312431995100_b45-0350276","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1136\/jnnp.2007.142430","article-title":"Long-term outcome in patients with critical illness myopathy or neuropathy: the Italian multicentre CRIMYNE study","volume":"79","author":"Guarneri","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["American Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/35\/4\/276\/170811\/276.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/35\/4\/276\/170811\/276.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T16:43:27Z","timestamp":1783097007000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article\/35\/4\/276\/33068\/Predicting-Nonrecovery-of-Muscle-Strength-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":45,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,7,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ajcc2026710","relation":{},"ISSN":["1062-3264","1937-710X"],"issn-type":[{"value":"1062-3264","type":"print"},{"value":"1937-710X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]}}}