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Review
. 2025 Mar 19;17(6):1073.
doi: 10.3390/nu17061073.

Combined Effects of Early Mobilization and Nutrition on ICU-Acquired Weakness

Paolo Formenti  1 , Alessandro Menozzi  2 , Giovanni Sabbatini  1 , Miriam Gotti  1 , Andrea Galimberti  1 , Giovanni Bruno  3 , Angelo Pezzi  1 , Michele Umbrello  4
Affiliations
Review

Combined Effects of Early Mobilization and Nutrition on ICU-Acquired Weakness

Paolo Formenti et al. Nutrients. .

Abstract

Intensive Care Unit-Acquired Weakness (ICUAW) is a very common condition in patients admitted to intensive care units (ICUs), even after relatively short stays. This weakness can develop with a pre-existing background of sarcopenia or cachexia, although these conditions are not always the direct cause. Over the years, much of the literature has focused on the nutritional aspect of the issue, leading to the development of widely accepted guidelines recommending the initiation of early nutrition, with the goal of achieving caloric and protein targets within the first five days of ICU admission. Despite adherence to these guidelines, several studies have shown a significant loss of muscle mass in critically ill patients, which directly impacts their ability to generate strength. However, it has become increasingly evident that nutrition alone is not sufficient to counteract this muscle loss, which is often closely linked to the prolonged immobility experienced by ICU patients due to a variety of clinical and logistical factors. In particular, there is growing evidence suggesting that even the introduction of early and minimal rehabilitation-including passive mobilization-when combined with appropriate nutritional support, can be a valuable strategy to help reduce the incidence of ICUAW. In this narrative review, we aim to summarize the current scientific knowledge on this topic, emphasizing the importance of an integrated approach that combines nutrition and early mobilization. Such a combined strategy not only holds the potential to reduce the acute incidence of ICUAW but also contributes to better recovery outcomes and, eventually, improved quality of life for these patients.

Keywords: ICU; ICUAW; nutrition; rehabilitation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Early mobilization benefits and temporal managing. This figure outlines the step-by-step process for implementing early mobilization in ICU patients. SMART = Specific, Measurable, Achievable, Realistic, and Time-bound; FITT = Frequency, Intensity, Time, and Type.
Figure 2
Figure 2
A concept map of early nutritional support. This figure illustrates the concept of ’early nutritional support’ and its impact on patient recovery.
Figure 3
Figure 3
Flow diagram of practical implications.
See this image and copyright information in PMC

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