Van der Merwe, ElizabethStroud, LouiseSharp, GaryVan Vuuren, NolineParuk, Fathima2025-10-292025-10-292025-08-12Van der Merwe, E., Stroud, L., Sharp, G., Van Vuuren, N. & Paruk, F., 2025, ‘Six-month trajectory of physical function in ICU survivors: Experience from an Eastern Cape centre’, South African Journal of Physiotherapy 81(1), a2228. https://doi.org/10.4102/sajp.v81i1.2228.0379-6175 (print)2410-8219 (online)10.4102/sajp.v81i1.2228http://hdl.handle.net/2263/105020DATA AVAILABILITY : The data that support the findings of our study are available on request from the corresponding author, E.v.d.M.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.en© 2025. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.Critical carePhysical impairmentICU-acquired neuromuscular weakness (ICU-AW)Medical Research Council scoreSix-minute walk testhealth-related quality of life (HRQOL)Post ICU painPost ICU syndromeIntensive care unit (ICU)Article