Related Experiment Video
Updated: Sep 3, 2026
Implementing In-bed Cycle Ergometry for Mechanically Ventilated Patients using the Rehabilitation Treatment Specification System
Published on: July 7, 2026
Systematic review and meta-analysis of physical rehabilitation on functional recovery in critically ill patients
Gang Wang1, Xinghua Li1, Linlin Fan1
1Department of Emergency Medicine, General Hospital of Central Theatre Command, Wuhan, Hubei, China.
Purpose:
Survivors of critical illness frequently experience persistent physical impairment, particularly ICU-acquired weakness (ICU-AW), which contributes to prolonged disability after intensive care. We conducted a systematic review and meta-analysis to evaluate the effects of physical rehabilitation on muscle strength, physical function, health-related quality of life, and clinical outcomes in critically ill adults.
Methods:
Four electronic databases were searched from inception to March 2026. Randomized controlled trials (RCTs) comparing physical rehabilitation with usual rehabilitation in adult critically ill patients were included. The primary outcome was muscle strength assessed by the Medical Research Council (MRC) sum score. Secondary outcomes included ICU-AW, physical function, health-related quality of life, duration of mechanical ventilation (MV), mortality, and ICU and hospital length of stay.
Results:
Forty RCTs involving 5,135 patients (2,554 physical rehabilitation; 2,581 usual rehabilitation) were included. Physical rehabilitation was associated with improved MRC sum score (SMD 0.26, 95% CI 0.05-0.46; p = 0.02; I 2 = 70%), reduced incidence of ICU-AW (OR 0.62, 95% CI 0.43-0.87; p = 0.007; I 2 = 34%), improved Barthel Index (SMD 0.62, 95% CI 0.21-1.03; p = 0.003; I 2 = 85%) and SF-36 physical function (SMD 0.53, 95% CI 0.26-0.81; p < 0.001; I 2 = 81%), shortened duration of MV (MD -1.32 days, 95% CI -1.98 to -0.65; p < 0.001; I 2 = 66%) and ICU length of stay (MD -1.41 days, 95% CI -2.03 to -0.78; p < 0.001; I 2 = 44%), but had no significant effects on mortality or hospital length of stay.
Conclusion:
Physical rehabilitation is associated with improved muscle strength and functional recovery, reduced ICU-AW, and shorter mechanical ventilation duration and ICU stay, but not reduced mortality. Further high-quality Multicenter trials are needed to define the optimal rehabilitation strategy.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD42023462649, Identifier CRD42023462649.
Related Concept Videos
01:30Specialized Care Centers and Settings-II
Rural health centers are specialized care facilities in remote locations with very few medical personnel. The primary care providers who run the centers are mostly Registered Nurse Practitioners. Here, emergency treatment is provided to critically ill or injured patients before they are transferred to the closest hospital. Fortunately, due to advancement in technology, many rural healthcare facilities and professionals have easy access to diagnostic and treatment...
01:19Restorative Care