# Occupational Therapy Intervention for Intensive Care Unit-Acquired Weakness: A Case Report

## TL;DR

A new occupational therapy strategy using a portable spring balancer helps patients with ICU-acquired weakness regain upper body strength and independence in daily tasks.

## Contribution

The paper introduces a novel occupational therapy approach combining a portable spring balancer and environmental modifications for ICU-AW rehabilitation.

## Key findings

- The patient showed significant improvement in upper extremity strength and ADL after the intervention.
- The use of a portable spring balancer and environmental adjustments enabled safe and effective rehabilitation.
- The patient regained independence in feeding and grooming post-treatment.

## Abstract

Intensive care unit-acquired weakness (ICU-AW) poses a challenge to physicians and paramedical staff. ICU-AW causes long-term limitations in patients’ daily lives; therefore, we aimed to devise an effective treatment strategy. We present a novel occupational therapy strategy for patients with ICU-AW.

We present the case of a 52-year-old male with ICU-AW developed by cardiogenic shock. The patient was bedridden all day at the start of occupational therapy. To improve upper extremity activity time, enhance muscle strength, and promote activities of daily living (ADL), we used a portable spring balancer (PSB) to support arm movements, modified the nurse call to be thicker, adjusted the bed’s head-up angle, and collaborated with nursing staff to facilitate daily practice. Training was structured around repetitive, goal-directed upper extremity exercises both on a bed or on a wheelchair. Following the intervention, the patient demonstrated marked improvements in upper extremity strength and ADL, and regained independence in feeding and grooming.

This case report suggests that PSB-assisted, goal-directed OT combined with environmental modifications may be a safe and effective rehabilitation strategy even for patients with severe ICU-AW.