# A COMPREHENSIVE EVIDENCE-BASED INTERVENTION PROGRAMME SIGNIFICANTLY REDUCES INTENSIVE CARE UNIT-ACQUIRED WEAKNESS AND IMPROVES FUNCTIONAL RECOVERY: A RETROSPECTIVE ANALYSIS

## TL;DR

A comprehensive care program in intensive care units significantly reduces muscle weakness and improves recovery in critically ill patients.

## Contribution

Demonstrates that a multimodal intervention program significantly reduces ICU-AW and improves functional outcomes compared to standard care.

## Key findings

- The intervention group had a 32.5% ICU-AW incidence versus 57.3% in standard care.
- Patients in the intervention group had shorter hospital stays and improved muscle strength and functional independence.

## Abstract

Intensive care unit-acquired weakness (ICU-AW) affects 25–50% of critically ill patients, resulting in prolonged hospitalization and impaired functional recovery. Despite recognition of its clinical importance, effective prevention and treatment strategies remain limited.

To evaluate the efficacy of a comprehensive evidence-based intervention programme on ICU-AW incidence and functional outcomes compared with standard care.

This retrospective analysis conducted between May 2021 and December 2023 included 420 critically ill patients allocated to either an evidence-based intervention group (n = 200) receiving a structured programme incorporating early mobilization, respiratory rehabilitation, swallowing training, psychological support, and nutritional optimization, or a standard care group (n = 220). Primary outcomes included ICU-AW incidence and hospital length of stay. Secondary outcomes comprised MRC muscle strength scores, nutritional status (Subjective Global Assessment), and functional independence (Barthel Index).

The evidence-based intervention group demonstrated significantly lower ICU-AW incidence (32.5% vs 57.3%, p < 0.001) and shorter hospital stays (18.4±6.2 days vs 25.7±7.8 days, p < 0.001) compared with standard care. Post-intervention MRC scores were significantly higher in the evidence-based intervention group (50.4±5.9 vs 44.2±7.1, p < 0.001), representing a mean improvement of 7.3 points (95% CI: 6.2–8.4) compared with 1.9 points (95% CI: 1.2–2.6) in standard care. Nutritional status improved by at least one SGA grade in 56% of evidence-based intervention patients vs 28.6% of standard care patients (p < 0.001). Barthel Index scores increased substantially more in the evidence-based intervention group (32.3-point increase vs 13.4-point increase, p < 0.001), with 41% achieving scores > 75 compared with 16% in standard care (p < 0.001).

A comprehensive evidence-based intervention programme significantly reduces ICU-AW incidence and improves muscle strength, nutritional status, and functional outcomes in critically ill patients. This multimodal strategy offers promise for alleviating ICU-AW’s burden and warrants broader clinical adoption.

When patients spend time in intensive care units, they often develop muscle weakness that makes it hard to move and care for themselves. This condition, called intensive care unit-acquired weakness, affects about 1 in 3 critically ill patients. In this study, we tested whether a comprehensive care program could help prevent and treat this weakness. The program included early physical exercises, breathing training, mental health support, and better nutrition planning. We compared 200 patients who received this special program with 220 patients who received standard intensive care unit care. Our results showed that patients in the special program were much less likely to develop severe weakness (32.5% versus 57.3%). They also got stronger faster, stayed in the hospital for shorter periods, and were better able to care for themselves when they left. This research suggests that a well-planned, multi-faceted approach to intensive care unit care can significantly improve patients' recovery and quality of life.