Intensive care unit acquired weakness and physical rehabilitation in the ICU

BMJ. 2025 Jan 27:388:e077292. doi: 10.1136/bmj-2023-077292.

Abstract

Approximately half of critically ill adults experience intensive care unit acquired weakness (ICUAW). Patients who develop ICUAW may have negative outcomes, including longer duration of mechanical ventilation, greater length of stay, and worse mobility, physical functioning, quality of life, and mortality. Early physical rehabilitation interventions have potential for improving ICUAW; however, randomized trials show inconsistent findings on the efficacy of these interventions. This review summarizes the latest evidence on the definition, diagnosis, epidemiology, pathophysiology, risks factors, implications, and management of ICUAW. It specifically highlights research gaps and challenges, with considerations for future research for physical rehabilitation interventions.

Publication types

  • Review

MeSH terms

  • Critical Care* / methods
  • Critical Illness* / rehabilitation
  • Humans
  • Intensive Care Units*
  • Length of Stay
  • Muscle Weakness* / diagnosis
  • Muscle Weakness* / epidemiology
  • Muscle Weakness* / etiology
  • Muscle Weakness* / physiopathology
  • Muscle Weakness* / rehabilitation
  • Physical Therapy Modalities*
  • Quality of Life
  • Respiration, Artificial
  • Risk Factors