IMPAIRED PHYSICAL MOBILITY IN POST-ICU PATIENTS: NURSING INTERVENTIONS FOR THE RECOVERY OF STRENGTH AND MUSCLE MASS
DOI:
https://doi.org/10.56238/levv16n54-077Keywords:
Nursing, Rehabilitation, Physical Mobility, Intensive Care UnitAbstract
Objective: To analyze, through an integrative literature review, the main nursing interventions aimed at recovering physical mobility, strength, and muscle mass in patients during the post-ICU period. Method: An integrative literature review was conducted using indexed databases (MEDLINE, BDENF, SciELO, and PubMed), including primary studies published between 2015 and 2025, in English and Portuguese, that addressed nursing interventions for the recovery of strength and muscle mass. Results and discussion: The integrative review identified 11 studies published between 2017 and 2025, mostly conducted in China. The most effective nursing interventions involved structured rehabilitation protocols, such as early mobilization, resistance exercises, and progressive multidisciplinary rehabilitation, which reduced hospital stay, improved muscle strength, and decreased complications such as thrombosis and ventilator-associated pneumonia. In parallel, expanded models of care, such as the FLS Nursing Model and home-based rehabilitation mediated by technology, showed a positive impact on functional recovery, self-efficacy, and quality of life. Final considerations: The findings reinforce the importance of nursing leadership in coordinating integrated care plans that connect physical, psychological, and educational dimensions in the rehabilitation of patients with impaired physical mobility after ICU hospitalization.
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References
ALAMRI, Majed S. et al. Effectiveness of an early mobility protocol for stroke patients in Intensive Care Unit. Neurosciences (Riyadh), v. 24, n. 2, p. 81-8, 2019. DOI: https://doi.org/10.17712/nsj.2019.2.20180004. Acesso em: 11 ago. 2025. DOI: https://doi.org/10.17712/nsj.2019.2.20180004
ASSOCIAÇÃO DE MEDICINA INTENSIVA BRASILEIRA (AMIB). O que é uma UTI? Orgulho de Ser Intensivista. Disponível em: https://orgulhodeserintensivista.org.br/. Acesso em: 11 ago. 2025.
AYENEW, Temesgen et al. Prevalence of post-intensive care syndrome among intensive care unit survivors: a systematic review and meta-analysis. PLOS One, v. 20, n. 1, e0323311, 2025. DOI: https://doi.org/10.1371/journal.pone.0323311. Acesso em: 14 ago. 2025. DOI: https://doi.org/10.1371/journal.pone.0323311
BAO, Liyun; WEI, Jurui; CHEN, Zhenping. The impact of progressive rehabilitation nursing on physical rehabilitation and quality of life in patients with cerebral infarction. Alternative Therapies in Health and Medicine, v. 30, n. 3, p. 62-7, 2024. Disponível em: https://pubmed.ncbi.nlm.nih.gov/37883759/. Acesso em: 14 ago. 2025.
BRASIL. Ministério da Saúde. Portaria nº 2.809/GM/MS, de 7 de dezembro de 2012. Institui a Atenção Domiciliar no âmbito do Sistema Único de Saúde (SUS). Brasília, DF: Ministério da Saúde, 2012. Disponível em: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2012/prt2809_07_12_2012.html. Acesso em: 14 ago. 2025.
BRASIL. Ministério da Saúde. Secretaria de Atenção Especializada à Saúde. Jornada do cuidado interdisciplinar ao paciente com síndrome pós-cuidados intensivos: da UTI ao domicílio. Brasília, DF: Ministério da Saúde, 2024. Disponível em: https://www.gov.br/saude/pt-br/composicao/saes/publicacoes/ebook-jornada-do-cuidado-interdisciplinar-ao-paciente-com-sindrome-pos-terapia-intensiva-pics-da-uti-ate-o-domicilio/view. Acesso em: 14 ago. 2025.
CAMPOS, Maria do Socorro de Vasconcelos; RACHED, Roberto Del Valhe Abi. O papel da enfermagem na reabilitação física. International Journal of Health Management Review, v. 3, n. 1, 2017. Disponível em: https://ijhmreview.org/ijhmreview/article/view/116. Acesso em: 14 ago. 2025. DOI: https://doi.org/10.21902/jhmreview.v3i1.116
CAO, Yafen et al. Analysis of the nursing effect of hemiplegic limb rehabilitation training in the care of stroke patients. Alternative Therapies in Health and Medicine, v. 31, n. 1, p. 408-13, 2025. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38607213/. Acesso em: 14 ago. 2025.
CARVALHO, Jainne Suellen Oliveira de; DAMASCENO, Geovane Alberto Costa; SILVA, Eric da. Mobilização precoce na unidade de terapia intensiva: revisão sistemática. Research, Society and Development, v. 11, n. 7, e57711730467, 2022. DOI: https://doi.org/10.33448/rsd-v11i7.30467. DOI: https://doi.org/10.33448/rsd-v11i7.30467
DICKINSON, Sharon; TAYLOR, Sarah; ANTON, Paula. Integrating a standardized mobility program and safe patient handling. Critical Care Nurse Quarterly, v. 41, n. 3, p. 240-52, 2018. DOI: https://doi.org/10.1097/CNQ.0000000000000202. Acesso em: 11 ago. 2025. DOI: https://doi.org/10.1097/CNQ.0000000000000202
MARRA, Annachiara et al. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness. Critical Care Medicine, v. 46, n. 9, p. 1393-1401, 2018. Disponível em: https://pubmed.ncbi.nlm.nih.gov/29787415/. Acesso em: 11 ago. 2025. DOI: https://doi.org/10.1097/CCM.0000000000003218
MELNYK, Bernadette Mazurek; FINEOUT-OVERHOLT, Ellen. Evidence-based practice in nursing and healthcare. Philadelphia: Lippincott Williams & Wilkins, 2005. DOI: https://doi.org/10.1037/t68160-000
NANDA INTERNACIONAL. Diagnósticos de Enfermagem da NANDA-I: definições e classificação 2024–2026. 13. ed. Porto Alegre: Artmed, 2024.
ROUSSEAU, Anne-Françoise et al. Long-term outcomes after critical illness: recent insights. Critical Care, v. 25, n. 1, p. 1-12, 2021. DOI: https://doi.org/10.1186/s13054-021-03535-3. Acesso em: 14 ago. 2025. DOI: https://doi.org/10.1186/s13054-021-03535-3
SINGAM, Amol et al. Mobilizing progress: a comprehensive review of the efficacy of early mobilization therapy in the intensive care unit. Cureus, v. 16, n. 4, e57595, 2024. DOI: https://doi.org/10.7759/cureus.57595. Acesso em: 14 ago. 2025. DOI: https://doi.org/10.7759/cureus.57595
SUN, Jing et al. Efficacy and safety of continuous nursing in improving functional recovery after total hip or knee arthroplasty in older adults: a systematic review. International Journal of Nursing Sciences, v. 11, p. 286-94, 2024. DOI: https://doi.org/10.1016/j.ijnss.2024.03.013. Acesso em: 12 ago. 2025. DOI: https://doi.org/10.1016/j.ijnss.2024.03.013
TANG, Yuanyuan; FU, Baihui; TONG, Qun. Implementation and evaluation of the FLS model nursing in the rehabilitation of geriatric patients with femoral neck fractures. Alternative Therapies in Health and Medicine, 2024. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38940811/. Acesso em: 12 ago. 2025.
TIPPING, Claire J. et al. The effects of active mobilisation and rehabilitation in ICU on mortality and function: a systematic review. Intensive Care Medicine, v. 43, p. 171-83, 2017. DOI: https://doi.org/10.1007/s00134-016-4612-0. Acesso em: 12 ago. 2025. DOI: https://doi.org/10.1007/s00134-016-4612-0
TRICCO, Andrea C. et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals of Internal Medicine, v. 2, n. 7, p. 467-73, 2018. DOI: https://doi.org/10.7326/M18-0850. Acesso em: 12 ago. 2025. DOI: https://doi.org/10.7326/M18-0850
VARGAS, Mara Ambrosina de Oliveira et al. Unidade de terapia intensiva: aspectos históricos e contextuais. In: ARGENTA, Carla; ADAMY, Edlamar Kátia; BITENCOURT, Julia Valeria de Oliveira Vargas (org.). Processo de enfermagem: da teoria à prática em cuidados intensivos. Chapecó: UFFS, 2022. p. 34-47. DOI: https://doi.org/10.7476/9786586545708.0002
WANG, Kaiwen; DAI, Shujia. Analysis of the effects of a goal-oriented pulmonary rehabilitation training program based on patients with ventilator withdrawal difficulties in the ICU. Medicine, v. 104, n. 33, e43846, 2025. DOI: https://doi.org/10.1097/MD.0000000000043846. Acesso em: 12 ago. 2025. DOI: https://doi.org/10.1097/MD.0000000000043846
WINKELMAN, Chris et al. Dose of early therapeutic Mobility: does frequency or intensity matter? Biological Research for Nursing, v. 20, n. 5, p. 522-30, 2018. DOI: https://doi.org/10.1177/1099800418780492. Acesso em: 11 ago. 2025. DOI: https://doi.org/10.1177/1099800418780492
XU, Jing et al. Effectiveness of nurse-led early mobility protocols on the outcomes of critical care patients: a systematic review and meta-analysis. Nursing Open, v. 12, e70206, 2025. DOI: https://doi.org/10.1002/nop2.70206. Acesso em: 11 ago. 2025. DOI: https://doi.org/10.1002/nop2.70206
ZANG, Kui et al. The effect of early mobilization in critically ill patients: a meta-analysis. Nursing in Critical Care, v. 25, n. 6, p. 360-7, 2019. DOI: https://doi.org/10.1111/nicc.12455. Acesso em: 14 ago. 2025. DOI: https://doi.org/10.1111/nicc.12455
