Original Research Six-month trajectory of physical function in ICU survivors: Experience from an Eastern Cape centre

Elizabeth van der Merwe, Louise Stroud, Gary Sharp, Noline van Vuuren, Fathima Paruk

South African Journal of Physiotherapy | Vol 81, No 1 | a2228 | DOI: https://doi.org/10.4102/sajp.v81i1.2228 | © 2025 Elizabeth van der Merwe, Louise Stroud, Gary Sharp, Noline van Vuuren, Fathima Paruk | This work is licensed under CC Attribution 4.0
Submitted: 07 April 2025 | Published: 12 August 2025

About the author(s) Elizabeth van der Merwe, Department of Critical Care, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa; and, Adult Critical Care Unit, Livingstone Hospital, Gqeberha, South Africa
Louise Stroud, Department of Psychology, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
Gary Sharp, Department of Statistics, Faculty of Science, Nelson Mandela University, Gqeberha, South Africa
Noline van Vuuren, Adult Critical Care Unit, Livingstone Hospital, Gqeberha, South Africa; and, Department of Health Sciences, Faculty of Health and Enviromental Sciences, Central University of Technology, Bloemfontein, South Africa
Fathima Paruk, Department of Critical Care, Steve Biko Academic Hospital, Pretoria, South Africa; and, Department of Critical Care, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa

Abstract

Background: Physical impairment affects up to 60% of intensive care unit (ICU) survivors due to factors such as ICU-acquired neuromuscular weakness (ICU-AW), chronic pain, deconditioning and reduced organ and metabolic function. This impairment is linked to lower health-related quality of life (HRQOL).

Objectives: Our study aimed to assess physical impairment and HRQOL among critically ill patients post hospital discharge.

Method: Intensive care unit survivors were assessed six weeks and six months post hospital discharge. Physical performance was evaluated using the six-minute walk test (6MWT) and muscle strength with the Medical Research Council (MRC) score. Patients’ HRQOL was determined using the Rand Short Form-36 questionnaire.

Results: A total of 107 patients (median age 42 years), including 50% with COVID-19, completed the 6-month follow-up. Although significant improvements were observed, 53.5% walked less than 80% of the predicted 6MWT distance at six months, with females disproportionately affected. Poor physical performance was associated with lower physical and mental HRQOL. Pain interfering with activities was reported by 26.2% at six months. Only 2% met full criteria for ICU-AW at six months. By six weeks, only 15% had attended physiotherapy.

Conclusion: Intensive care unit survivors exhibited a high incidence of physical impairment and pain at six months, impacting HRQOL. Very few patients met full ICU-AW criteria.

Clinical implications: Physical impairment after critical illness is multifactorial and is not only attributable to muscle weakness. The recovery process of young, previously non-frail ICU survivors in the public healthcare setting may be improved by introducing rehabilitation pathways.

Keywords

critical care; physical impairment; ICU-acquired weakness; Medical Research Council score; six-minute walk test; health-related quality of life; post ICU pain; post ICU syndrome

Sustainable Development Goal

Goal 3: Good health and well-being

Metrics Total abstract views: 127
Total article views: 113

Crossref Citations

No related citations found.