Recovery of Physical Function in a Patient with Intensive Care Unit-acquired Weakness after Valvular Surgery: A Case Report

Abstract

Objectives: This report describes the functional recovery of a patient who developed severe intensive care unit-acquired weakness (ICUAW) following aortic valve replacement (AVR). It focuses on the utility of preoperative physical function assessment and changes in patient-reported health-related quality of life (HRQOL). Case Presentation: The patient was a woman in her 70s who developed ICUAW after undergoing AVR. Preoperative assessments included the Barthel Index (BI), Short Physical Performance Battery, gait speed, and grip strength to evaluate physical function, and the EuroQol 5 Dimensions 3 Levels (EQ-5D-3L) to assess HRQOL. A progressive rehabilitation program was initiated after the surgery. Postoperatively, we regularly assessed the Medical Research Council sum score (MRCss) and functional performance metrics, and we tracked HRQOL using the EQ-5D-3L over time. Discussion: The MRCss of the patient was 16 at ICU discharge, indicating severe muscle weakness. Based on preoperative assessments, tailored rehabilitation goals were set, and the patient was transferred to a post-acute rehabilitation facility. The HRQOL trajectory reached its lowest score on postoperative day (POD) 27 (EQ-5D-3L: −0.166) but gradually improved over time. By POD 102, the patient had achieved near-complete functional recovery with an MRCss of 57, BI of 95, gait speed of 1.33 m/s, and EQ-5D-3L of 0.746 and was discharged. Conclusions: Functional recovery may be possible even in cases of severe ICUAW with marked muscle weakness at ICU discharge. Preoperative physical function assessments may provide valuable insights into recovery potential and guide rehabilitation planning, thereby contributing to an improved quality of care.