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Original Research

Open Access

Application effect of nutritional support combined with early motion based on protection motivation theory in ICU-acquired weakness

  • Yi Zhang1
  • Yue Qiu1
  • Lili Sun1,*,

1Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of SuZhou University, 215000 Suzhou, Jiangsu, China

DOI: 10.22514/sv.2023.063 Vol.19,Issue 4,July 2023 pp.187-193

Submitted: 03 January 2023 Accepted: 13 February 2023

Published: 08 July 2023

*Corresponding Author(s): Lili Sun E-mail:


To explore the effect of nutritional support combined with early motion based on protection motivation theory in acquired weakness in critically ill patients. Patients treated in Intensive care unit (ICU) after operation from January to December in 2021 were selected as the study subjects. Historial control trial (HCT) was used. Patients admitted from January to June were the control group, and those admitted from July to December were the intervention group. Routine ICU management was used in the control group, and early motion combined with nutritional support was used in the intervention group. The incidence of ICU-acquired weakness (ICU-AW), activities of daily living (ADL), nutritional status, ICU stay, total hospital stay along with mechanical ventilation time were compared between the control and intervention groups. Before intervention, there was no significant difference among PatientGenerated Subjective Global Assessment (PG-SGA) score, serum total protein (TP) and albumin (ALB) between the control and intervention groups. After intervention, the incidence of ICU-AW, Barthel (BI) score, PG-SGA score, serum TP and ALB in the intervention group were conspicuously better in comparison with control group. The ICU stay, mechanical ventilation time and total hospital stay were significantly shorter than that in the control group. Nutritional support combined with early motion based on protection motivation theory can abate the incidence of ICU-AW, improve the activities of daily living and the nutritional status of patients, and shorten the hospital stay and mechanical ventilation.


ICU-AW; Protection motivation theory; Early motion; Nutritional support

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Yi Zhang,Yue Qiu,Lili Sun. Application effect of nutritional support combined with early motion based on protection motivation theory in ICU-acquired weakness. Signa Vitae. 2023. 19(4);187-193.


[1] Vanhorebeek I, Latronico N, Van den Berghe G. ICU-acquired weakness. Intensive Care Medicine. 2020; 46: 637–653.

[2] Zhang L, Hu W, Cai Z, Liu J, Wu J, Deng Y, et al. Early mobilization of critically ill patients in the intensive care unit: a systematic review and meta-analysis. PLoS One. 2019; 14: e0223185.

[3] Doiron KA, Hoffmann TC, Beller EM. Early intervention (mobilization or active exercise) for critically ill adults in the intensive care unit. Cochrane Database of Systematic Reviews. 2018; 3: CD010754.

[4] Nakanishi N, Takashima T, Oto J. Muscle atrophy in critically ill patients: a review of its cause, evaluation, and prevention. The Journal of Medical Investigation. 2020; 67: 1–10.

[5] Zhou W, Shi B, Fan Y, Zhu J. Effect of early activity combined with early nutrition on acquired weakness in ICU patients. Medicine. 2020; 99: e21282.

[6] Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clinical Nutrition. 2019; 38: 48–79.

[7] Mart MF, Pun BT, Pandharipande P, Jackson JC, Ely EW. ICU survivorship-the relationship of delirium, sedation, dementia, and acquired weakness. Critical Care Medicine. 2021; 49: 1227–1240.

[8] Anekwe DE, Biswas S, Bussières A, Spahija J. Early rehabilitation reduces the likelihood of developing intensive care unit-acquired weakness: a systematic review and meta-analysis. Physiotherapy. 2020; 107: 1–10.

[9] Zhang Y, Cao S, Lin B, Chen J, Chen X, Lin S, et al. A best evidence synthesis in practicing early active movements in ICU patients with mechanical ventilation. American Journal of Translational Research. 2021; 13: 11948–11957.

[10] Vollenweider R, Manettas AI, Häni N, de Bruin ED, Knols RH. Passive motion of the lower extremities in sedated and ventilated patients in the ICU—a systematic review of early effects and replicability of interventions. PLoS One. 2022; 17: e0267255.

[11] Pan C, Dou Y, Zhu Q, Guo L, Chang S, Shan X, et al. Observation of the effect of Multi-disciplinary team for early exercise on the prevention of ICU-acquired weakness in patients with mechanical ventilation. Tianjin Journal of Nursing. 2019; 27: 417–419.

[12] Song J, Zhong Y, Lu X, Kang X, Wang Y, Guo W, et al. Enteral nutrition provided within 48 hours after admission in severe acute pancreatitis: a systematic review and meta-analysis. Medicine. 2018; 97: e11871.

[13] Allen K, Hoffman L. Enteral nutrition in the mechanically ventilated patient. Nutrition in Clinical Practice. 2019; 34: 540–557.

[14] Schuetz P, Fehr R, Baechli V, Geiser M, Deiss M, Gomes F, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. The Lancet. 2019; 393: 2312–2321.

[15] Saijo T, Yasumoto K, Ohashi M, Momoki C, Habu D. Association between early enteral nutrition and clinical outcome in patients with severe acute heart failure who require invasive mechanical ventilation. Journal of Parenteral and Enteral Nutrition. 2022; 46: 443–453.

[16] Sun JK, Zhang WH, Chen WX, Wang X, Mu XW. Effects of early enteral nutrition on Th17/Treg cells and IL-23/IL-17 in septic patients. World Journal of Gastroenterology. 2019; 25: 2799–2808.

[17] Fuentes Padilla P, Martínez G, Vernooij RW, Urrútia G, Roqué I Figuls M, Bonfill Cosp X. Early enteral nutrition (within 48 hours) versus delayed enteral nutrition (after 48 hours) with or without supplemental parenteral nutrition in critically ill adults. Cochrane Database of Systematic Reviews. 2019; 2019: CD012340.

[18] Koontalay A, Sangsaikaew A, Khamrassame A. Effect of a clinical nursing practice guideline of enteral nutrition care on the duration of mechanical ventilator for critically ill patients. Asian Nursing Research. 2020; 14: 17–23.

[19] McKendry J, Thomas ACQ, Phillips SM. Muscle mass loss in the older critically ill population: potential therapeutic strategies. Nutrition in Clinical Practice. 2020; 35: 607–616.

[20] Koontalay A, Suksatan W, Teranuch A. Early enteral nutrition met calories goals led by nurse on improve clinical outcome: a systematic scoping review. Iranian Journal of Nursing and Midwifery Research. 2021; 26: 392–398.

[21] de Azevedo JRA, Lima HCM, Frota P, Nogueira IROM, de Souza SC, Fernandes EAA, et al. High-protein intake and early exercise in adult intensive care patients: a prospective, randomized controlled trial to evaluate the impact on functional outcomes. BMC Anesthesiology. 2021; 21: 283.

[22] Wernhart S, Hedderich J, Wunderlich S, Schauerte K, Weihe E, Dellweg D, et al. The feasibility of high-intensity interval training in patients with intensive care unit-acquired weakness syndrome following long-term invasive ventilation. Sports Medicine—Open. 2021; 7: 11.

[23] Heyland DK, Day A, Clarke GJ, Hough CT, Files DC, Mourtzakis M, et al. Nutrition and exercise in critical illness trial (NEXIS trial): a protocol of a multicentred, randomised controlled trial of combined cycle ergometry and amino acid supplementation commenced early during critical illness. BMJ Open. 2019; 9: e027893.

[24] Ceniccola GD, Okamura AB, Sepúlveda Neta JDS, Lima FC, Santos de Deus AC, de Oliveira JA, et al. Association between AND-ASPEN malnutrition criteria and hospital mortality in critically ill trauma patients: a prospective cohort study. Journal of Parenteral and Enteral Nutrition. 2020; 44: 1347–1354.

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