Eri Yanuar Akhmad Budi Sunaryo, Huan-Fang Lee, Lili Sofia, Zaiching Peng, Hsin-Yu Tsai, Wei-Tien Lee
Background: Intensive care unit-acquired weakness (ICU-AW) causes prolonged hospitalisations and higher mortality. Systematic reviews and meta-analyses (SR/MA) regarding ICU-AW and early rehabilitation need a synthesis of the existing evidence. Aim: The aim of this study was to summarise findings from several SR/MA to provide an overview of early rehabilitation as a means to prevent ICU-AW. Study Design: This was an umbrella review of SR/MA. Preferred Reporting Items for Systematic Reviews and Meta-Analysis and Joanna Briggs Institute guidelines were used for the process. MEDLINE, Embase, Cochrane Database of Systematic Reviews and Airiti Library were searched for keywords. A search was conducted for papers published from the inception of the databases up to January 2025. Neither language nor publication year was restricted. A meta-analyses would be conducted if there were inconsistencies in the current SR/MA. Results: An analysis of seven SRs with a quality above medium was conducted. Sixty-nine primary studies from seven SRs discussed early rehabilitation in preventing ICU-AW. According to meta-analyses, early rehabilitation can significantly reduce the incidence of ICU-AW, with a risk difference of −0.10 (95% CI: −0.18 to −0.03, z = 2.580, p = 0.010). Subgroup analysis further revealed that initiating rehabilitation within 1–3 days of ICU admission was associated with a 13% lower risk of ICU-AW (RD: −0.13; 95% CI: −0.22 to −0.04; z = 2.92; p = 0.003). Other subgroup analyses showed no statistically significant differences. The type of early rehabilitation that was most effective could not be determined due to the variability in interventions and outcomes. Conclusions: Early rehabilitation could significantly prevent ICU-AW incidence. The meta-analysis indicated that the early rehabilitation group has a 10% lower ICU-AW incidence risk. Relevance to Clinical Practice: Providing early rehabilitation should be a nursing priority in the ICU in order to prevent ICU-AW and enhance patient recovery. © 2025 British Association of Critical Care Nurses.
Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan; School of Nursing, Faculty of Medicine, State University of Malang, Malang, Indonesia; Taiwan Holistic Care Evidence Implementation Center: A JBI Affiliation Center, Taichung City, Taiwan; General Intensive Care Unit, Dr Hasan Sadikin Public Hospital, Bandung, Indonesia
