Effect of Early Rehabilitation Interventions on ICU-Acquired Weakness Prevention in Critically Ill Patients | ||||
Alexandria Scientific Nursing Journal | ||||
Volume 27, Issue 3, September 2025, Page 200-218 PDF (373.47 K) | ||||
Document Type: Research articles | ||||
DOI: 10.21608/asalexu.2025.450089 | ||||
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Authors | ||||
Sherouk Nasser Mohamed* 1; Nadia Taha Mohamed Ahmed2; Bassem Nashaat Beshe3; Eman Arafa Hassan Ali4 | ||||
1Assistant lecturer Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University | ||||
2Professor Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University | ||||
3Professor Critical Care Medicine, Faculty of Medicine, Alexandria University | ||||
4Assistant professor Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University | ||||
Abstract | ||||
Background: Intensive care unit-acquired weakness (ICUAW) is an acute neuromuscular impairment that occurs frequently in the context of critical illness. ICUAW is associated with prolonged MV, increased length of ICU stay, increased healthcare-related costs, long-term disability, higher ICU, and hospitalization mortality. ICUAW prevention depends mainly on nursing preventive measures, including early rehabilitation, which includes positioning and motion exercises (active, passive, and active-assisted) for each joint combined with neuromuscular electrical stimulant NMEs. Objective: Determine the effect of early rehabilitation intervention on ICU-Acquired weakness prevention in critically ill patients. Settings: The study was carried out in four adult ICUs, namely unit II, unit III, unit IV, and the CRRT unit at the Alexandria Main University, Egypt. Subjects: A convenient sample of 80 adult patients who were newly admitted to the previously mentioned ICUs. The sample was divided into two equal groups (40 patients each in the group). Tools: Three tools were used. Tool one: “Intensive care unit acquired weakness associated factors assessment". Tool Two:" Physiological parameters and laboratory investigation assessment record". Tool Three: "Effect of early rehabilitation interventions assessment". Results: Following the implementation of the early rehabilitation intervention, on day sixth, there was a marked increase in ICUAW among control patients at 85%, with a lower severity according to a mean MRC score of 43.00 ± 4.95 compared to just 15% occurrence in the study group with a higher severity according to a mean MRC score of 55.88 ± 5.93. This difference was highly statistically significant (χ2=39.29 p=<0.001). Conclusion: Critically ill patients who are subjected to early rehabilitation interventions exhibit lower ICU-acquired weakness scores than those who are not subjected. Also, the frequency of ICUAW occurrence was higher in patients who did not receive early rehabilitation intervention. So, early rehabilitation is a protective factor against the occurrence and severity of ICUAW. Recommendations: Implement early NMES sessions for half an hour combined with early passive ROM exercises for half an hour for upper and lower extremity joints from the first 24 hours of admission for one hour till patients discharge from the ICU. Assess the muscle strength of all admitted patients to the ICU using a muscle strength scale and hand grip scale as a routine by nurses and medical staff. | ||||
Keywords | ||||
Early Rehabilitation Interventions; ICU-Acquired Weakness Prevention; Critically ill patients | ||||
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