Objective To examine the association between the mobilization level during intensive care unit (ICU) admission and independence in activity of daily living (ADL), defined as Barthel Index (BI)≥70.
Methods This was a post-hoc analysis of the EMPICS study involving nine hospitals. Consecutive patients who spend >48 hours in the ICU were eligible for inclusion. Mobilization was performed at each hospital according to the shared protocol and the highest ICU mobility score (IMS) during the ICU stay, baseline characteristics, and BI at hospital discharge. Multiple logistic regression analysis, adjusted for baseline characteristics, was used to deter-mine the association between the highest IMS (using the receiver operating characteristic [ROC]) and ADL.
Results Of the 203 patients, 143 were assigned to the ADL independence group and 60 to the ADL dependence group. The highest IMS score was significantly higher in the ADL independence group than in the dependence group and was a predictor of ADL independence at hospital discharge (odds ratio, 1.22; 95% confidence interval, 1.07–1.38; adjusted p=0.002). The ROC cutoff value for the highest IMS was 6 (specificity, 0.67; sensitivity, 0.70; area under the curve, 0.69).
Conclusion These results indicate that, in patients who were in the ICU for more than 48 hours, that patients with good function in the ICU also exhibit good function upon discharge. However, prospective, multicenter trials are needed to confirm this conclusion.
Citations
Citations to this article as recorded by
Health-Related Quality of Life and Mobility Levels in ICU Survivors with Heel Pressure Ulcer: An Observational Study Filippo Binda, Federica Marelli, Veronica Rossi, Lucia Villa, Andrea Cislaghi, Giacomo Grasselli Nursing Reports.2026; 16(1): 30. CrossRef
Impact of Preexisting Diabetes on Activities of Daily Living Independence at Hospital Discharge in Critically Ill Patients: A Prospective Cohort Study Shinichi Watanabe, Kota Yamauchi, Yuji Naito, Ayato Shinohara, Yasunari Morita, Yuki Iida Diabetology.2026; 7(2): 27. CrossRef
Occupational Therapy in the Intensive Care Unit: A Retrospective Cohort Study So Hyun Jeon, Sung Eun Hyun, Chae Hyeon Lee, Yeong Ae Yang, Shashank Kaushik Occupational Therapy International.2026;[Epub] CrossRef
Definitions and Prognoses of Persistent Inflammation, Immunosuppression, and Catabolism Syndrome: A Comparative Analysis via Systematic Review and Observational Study in Japan Shinya Suganuma, Naoki Kanda, Minoru Yoshida, Hayabusa Takano, Hideaki Sakuramoto, Akane Kariya, Hiroyuki Ohbe, Kensuke Nakamura Critical Care Medicine.2026;[Epub] CrossRef
Factors associated with functional recovery after intensive care unit discharge in patients with mechanical ventilation: A multi-centre prospective observational study Kota Yamauchi, Shinichi Watanabe, Yuji Naito, Kei Goto, Shota Tanaka, Tokuaki Shinya, Yoshihisa Fujino, Kazuki Ogawa, Tomohiro Yoshikawa, Yoshie Hirota Clinical Rehabilitation.2025; 39(7): 945. CrossRef
Impact of Early Rehabilitation Initiation on Walking Recovery in Critically Ill Patients Ryuji Yoshinaga, Narumi Yamada, Ryo Kozu Cureus.2025;[Epub] CrossRef
Balancing Rehabilitation Dose in Acute Stroke Decision-Making and Global Assessment (The BRIDGE Study) Shinichi Watanabe, Wataru Yamauchi, Katsuma Shoka, Asahi Kawashima, Shogo Sawamura, Kousuke Kanamori, Tetsuya Furukawa, Yuji Naito, Naoki Takeshita, Keita Utiyama, Rtota Imai, Kanari Kiritani, Naoyuki Hashimoto, Hideaki Tanaka, Yushi Mitani, Takayuki Kita Journal of Clinical Medicine.2025; 14(19): 6786. CrossRef
Factors associated with functional independence at hospital discharge and 6 months post-hospitalization in intensive care unit survivors with cancer: A prospective cohort study Gustavo Telles da Silva, Lavinia Gomes Cavalcante, Maria Luiza Valério Dalzini, Leda Tomiko Yamada da Silveira, Débora Stripari Schujmann, Carolina Fu Supportive Care in Cancer.2025;[Epub] CrossRef
Association between changes in disease severity and physical function after surviving a critical illness: A multicentre retrospective observational study Keibun Liu, Tomohiro Hamagami, Naoki Sugiyasu, Kenji Fujizuka, Akira Kawauchi, Sou Yamada, Takayuki Ogura, Naoko Hirata, Takafumi Tani, Shunsuke Taito, Kohei Ota, David McWilliams, Hajime Katsukawa, Toru Kotani Australian Critical Care.2024; 37(6): 889. CrossRef
Objective To discuss the association between the length of stay at the intensive care unit (ICU) and sarcopenia among hemiplegic stroke patients.
Methods This study evaluated 66 hemiplegic stroke patients with history of ICU admission using handgrip strength and bioelectrical impedance analysis to obtain height-adjusted appendicular skeletal muscle mass. The diagnosis of sarcopenia was made according to the muscle mass based on the Asian Working Group for Sarcopenia. The patients were divided into sarcopenic and non-sarcopenic groups. The two groups were statistically analyzed, and the significant factors with differences were studied. A multivariate logistic regression analysis was performed to examine the association between length of stay in the ICU and sarcopenia, after adjusting for potential confounders.
Results Among 66 hemiplegic patients with an ICU admission history, 12 patients were diagnosed with sarcopenia. Sarcopenia patients showed lower scores on the Korean version of the Modified Barthel Index and the Korean version of the Mini-Mental State Examination. Additionally, patients with sarcopenia had a longer length of stay in the ICU, and univariate and multivariate analyses confirmed that the ICU length of stay was significantly related to sarcopenia (adjusted odds ratio=1.187; 95% confidence interval, 1.019–1.382; p=0.028).
Conclusion The length of stay in the ICU was significantly associated with sarcopenia in hemiplegic stroke patients.
Citations
Citations to this article as recorded by
Upper extremity muscle thickness and grip strength following a boccia-based intervention in hemiparetic individuals Emre Berk Hazar, Betül Canbolat Güder, Kürşat Hazar, Umut Diyar Gök, Nouf H. Alkhamees, Zizi M. Ibrahim, Sameer Badri Al-Mhanna, Alexios Batrakoulis BMC Sports Science, Medicine and Rehabilitation.2026;[Epub] CrossRef
The importance of sarcopenia in the prediction of outcomes of acute cerebral insufficiency in patients with post-intensive care syndrome: descriptive prospective cohort study Vadim I. Ershov, A. S. Dobrynin, T. V. Biryukova, N. O. Davydova Annals of Critical Care.2026; (3): 137. CrossRef
Associated factors for stroke-related sarcopenia: a scoping review Fanchi Xu, Yaqin You, Yijing Ling, Yehong Wei, Meng Hu Frontiers in Neurology.2026;[Epub] CrossRef
Usefulness of body composition assessment by bioelectrical impedance vector analysis in subacute post-stroke patients in rehabilitation Alessandro Guerrini, Mariacristina Siotto, Carola Cocco, Marco Germanotta, Valeria Cipollini, Laura Cortellini, Arianna Pavan, Stefania Lattanzi, Sabina Insalaco, Yeganeh Manon Khazrai, Irene Giovanna Aprile Scientific Reports.2025;[Epub] CrossRef
HANDGRIP STRENGTH AND DASH EATING BEHAVIOR IS RELATED TO HIGHER BLOOD PRESSURE ON PRE-ELDERLY AND ELDERLY IN YOGYAKARTA Adhila Fayasari, Anis Febri Nilansari, Margala Juang Bertorio Media Gizi Indonesia.2025; 20(2): 135. CrossRef
Effects of Leucine Supplementation in Older Adults with Sarcopenia: A Meta-Analysis Chienhsiu Huang, Min-Hong Hsieh Nutrients.2025; 17(15): 2413. CrossRef
Post-Operative Atrial Fibrillation: Novel Predictive Value of CT-Derived Adipose Tissue Density in Minimally Invasive Mitral Surgery M Pekar, D Vician, O Jiravsky, B Jiravska Godula, P Branny, R Spacek, M Kantor, M Skotakova, J Chovancik, L Sknouril, J Novak Physiological Research.2025; : S117. CrossRef
Indirect calorimetry directed feeding and cycling in the older ICU population: a pilot randomised controlled trial Ng Shu Hui Elizabeth, Tan Yanni, Leong Siaw May, Tiong Hui Fen, Li Xuanhui Janice, Kwan Peijun, Ong Sze Pheng, Toh Shi Jie, Loh Ne Hooi Will BMC Anesthesiology.2024;[Epub] CrossRef
Effects of Brunnstrom movement therapy versus mirror therapy on hand function in post-stroke hemiplegic population Nimra, Ayesha Zulifiqar, Muhammad Umair Javaid, Reham Ali Mohamed Ali Ahmed Journal of Musculoskeletal Surgery and Research.2024; 8: 389. CrossRef
Association between handgrip strength and small airway disease in patients with stable chronic obstructive pulmonary disease Thanapon Keawon, Narongkorn Saiphoklang Therapeutic Advances in Respiratory Disease.2024;[Epub] CrossRef
Trunk Impairment Scale for Predicting Lumbar Spine Bone Mineral Density in Young Male Patients With Subacute Stroke Yeon Hee Cho, Hyun Seok, Sang-Hyun Kim, Seung Yeol Lee, Hyun Jung Kim Annals of Rehabilitation Medicine.2023; 47(2): 98. CrossRef
Accuracy of Calf Circumference Measurement, SARC-F Questionnaire, and Ishii's Score for Screening Stroke-Related Sarcopenia Ruihong Yao, Liqing Yao, Changli Yuan, Bu-Lang Gao Frontiers in Neurology.2022;[Epub] CrossRef
Natural aging course of lumbar extensor muscle mass and strength in community-dwelling older women: a 1-year prospective observational study Dong Hyun Kim, Jinhee Park, Chang Won Lee, Sang Yoon Lee Aging Clinical and Experimental Research.2022; 34(9): 2099. CrossRef
Prognostic Value of Isolated Sarcopenia or Malnutrition–Sarcopenia Syndrome for Clinical Outcomes in Hospitalized Patients Iasmin Matias Sousa, Camila Ferri Burgel, Flávia Moraes Silva, Ana Paula Trussardi Fayh Nutrients.2022; 14(11): 2207. CrossRef
Effects of leucine-rich protein supplements in older adults with sarcopenia: A systematic review and meta-analysis of randomized controlled trials Sang Yoon Lee, Hyun Jeong Lee, Jae-Young Lim Archives of Gerontology and Geriatrics.2022; 102: 104758. CrossRef
Relationship between Nutritional Status, Food Consumption and Sarcopenia in Post-Stroke Rehabilitation: Preliminary Data Mariacristina Siotto, Marco Germanotta, Alessandro Guerrini, Simona Pascali, Valeria Cipollini, Laura Cortellini, Elisabetta Ruco, Yeganeh Manon Khazrai, Laura De Gara, Irene Aprile Nutrients.2022; 14(22): 4825. CrossRef
Handgrip Strength: An Irreplaceable Indicator of Muscle Function Sang Yoon Lee Annals of Rehabilitation Medicine.2021; 45(3): 167. CrossRef
First
Prev
