{
  "abstract": "Objective To compare the effects of early physical interventions on the prevention of intensive care unit-acquired weakness (ICUAW) and the improvement of relevant clinical outcomes in patients with critical illness.Methods We systematically searched the Web of Science, PubMed, Embase and the Cochrane Central Register of Controlled Trials from their inception until 20 August 2024, to identify randomised controlled trials (RCTs) enrolling patients ≥18 years old and implementing early physical intervention that commenced at any time point during mechanical ventilation (MV) use or within 7 days after intensive care unit (ICU) admission for review. We synthesised data using a random-effects model and analysed through network meta-analysis (NMA) and component network meta-analysis (CNMA).Main outcome measures Primary outcome is the incidence of ICUAW. Secondary outcomes included Medical Research Council sum score, length of stay in the ICU or hospital, duration of MV and mortality rates in the ICU or hospital.Results Our analyses included 63 RCTs involving 24 treatments and eight components. The NMA results revealed systematic early mobilisation (SEM) combined with neuromuscular electrical stimulation (NMES), SEM alone and NMES alone may lead to a moderate to large reduction in the incidence of ICUAW (odds ratios [ORs]=0.03, 0.09 and 0.12, 95% confidence intervals [CIs]=0.00 to 0.42, 0.01 to 0.97 and 0.03 to 0.44, respectively) and improved relevant clinical outcomes compared with routine care. The CNMA results further indicated that SEM (OR=0.14, 95% CI=0.02 to 0.83) and NMES (OR=0.22, 95% CI=0.09 to 0.52) effectively mitigated the ICUAW incidence.Conclusions SEM and NMES are optimal interventions for preventing ICUAW. Healthcare providers in ICUs should implement early mobilisation with structured protocols and patient assessments or apply NMES to specific muscle groups to prevent ICUAW in critically ill patients and improve relevant clinical outcomes.PROSPERO registration number CRD42024581173.",
  "authors": [
    {
      "affiliations": [
        "School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan",
        "School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia"
      ],
      "name": "Kai-Mei Chang"
    },
    {
      "affiliations": [
        "Institute of Health Data Analytics and Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan",
        "Health Data Research Center, National Taiwan University, Taipei, Taiwan"
      ],
      "name": "Yu-Kang Tu"
    },
    {
      "affiliations": [
        "School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan"
      ],
      "name": "Chia-Rung Wu"
    },
    {
      "affiliations": [
        "School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia",
        "School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia"
      ],
      "name": "Kath Peters"
    },
    {
      "affiliations": [
        "School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia",
        "Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia"
      ],
      "name": "Lucie Ramjan"
    },
    {
      "affiliations": [
        "Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan",
        "Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan",
        "Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan",
        "School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan",
        "Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan"
      ],
      "name": "Wen-Hsuan Hou"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan",
        "Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"
      ],
      "name": "Sen-Kuang Hou"
    },
    {
      "affiliations": [
        "School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan",
        "Nursing Department, Vinmec Times City International Hospital, Vinmec Healthcare System, Hanoi, Vietnam"
      ],
      "name": "Nguyen Thi Phuc"
    },
    {
      "affiliations": [
        "School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan",
        "Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan"
      ],
      "name": "Hsiao-Yean Chiu"
    }
  ],
  "title": "Comparative effects of early physical interventions on preventing intensive care unit-acquired weakness: a systematic review and component network meta-analysis",
  "uid": "006644cd-338e-50ce-81ae-cd039d3c1158"
}