DOI: 10.1177/03601293261472164 ISSN: 0360-1293

Impact of Multidisciplinary Integrated Rehabilitation on ICU-Acquired Weakness in Critically Ill Patients: A Prospective Cohort Study on Clinical Efficacy, Functional Recovery, and Correlation Analysis

Hongfei Wang, Yin Li
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Background

ICU-acquired weakness (ICU-AW) affects 25%–65% of critically ill patients, prolonging ventilation and hospitalization, impairing quality of life, and increasing mortality.

Objective

To assess MIR's effect on ICU-AW, functional recovery, and links to clinical, inflammatory, and nutritional markers.

Methods

This prospective, nonrandomized controlled trial at a single center enrolled 237 ventilated ICU patients (July 2022–July 2025). Patients were divided into control ( n  = 115, usual care) and MIR ( n  = 122, usual care plus six-part rehab). Primary endpoint: ICU-AW incidence. Secondary endpoints: ICU stay, ventilation duration, 90-day mortality, MRC score at ICU discharge, Berg balance score, change in diaphragmatic excursion, rapid shallow breathing index, and peak expiratory flow at weaning. Correlations between day-14 IL-6/CRP and functional recovery were explored. Age, sex, APACHE II, and baseline MRC were adjusted.

Results

Baseline data matched except RASS and prealbumin. MIR group had lower ICU-AW incidence (RR = 0.18), shorter ventilation (9.3 vs. 15.3 days), ICU stay (14.6 vs. 21.4 days), and lower 90-day mortality (20.5% vs. 38.3%; P  < 0.01). At discharge, MIR patients outperformed controls in MRC score, Berg balance, diaphragmatic excursion, and weaning indices ( P  < 0.001). Weak negative links were noted between IL-6/CRP and functional recovery, and a weak positive link for albumin ( r  ≈ 0.18–0.19; P  < 0.01). Multivariate analysis identified MIR as an independent predictor of MRC score (β = 6.32; P  < 0.001) and a strong protective factor against ICU-AW (OR = 0.055; P  < 0.001).

Conclusion

MIR lowers ICU-AW risk, cuts ventilation and hospital stay, reduces 90-day death rate, and aids muscle, balance, and diaphragm recovery. Inflammation/nutrition changes weakly correlate with functional gain.

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