摘要Background::Recovery of activities of daily living (ADL) is a key outcome for critically ill patients following intensive care unit (ICU) admission. However, the relationship between early rehabilitation parameters and ADL recovery remains unclear.Methods::This post hoc secondary analysis of the IPAM study (UMIN000047578), a multicenter prospective cohort, included adult ICU patients who required mechanical ventilation. Patients with pre-existing walking dependence, neurological or mental disorders, or terminal conditions were excluded. Five rehabilitation parameters were assessed during ICU stay: dose (mean Mobilization Quantification Score [MQS]), intensity (highest ICU mobility scale [IMS]), duration, frequency, and start time. The primary outcome was the Barthel index (BI), measured at five time points: prehospitalization, ICU discharge, day 7, day 14, and hospital discharge or day 28, whichever came first. Patients were categorized into three groups based on ADL recovery: early recovery (BI ≥85 within 14 days post-ICU), recovery (BI ≥ 85 by discharge), and delayed recovery (BI <85 by discharge). Multinomial logistic regression was used to assess associations. Results::Among 121 eligible patients, 28.9% achieved early recovery, 28.9% recovery, and 42.2% delayed recovery. Patients in the early recovery group had significantly higher mean MQS (median=6.7, interquartile range [IQR]: 4.1-12.6 vs. median=2.3, IQR: 0.8-3.3 in the delayed group; P <0.001) and Medical Research Council (MRC) scores (median=54.0, IQR: 48.0-58.0 vs. median=39.5, IQR: 24.0-50.5; P <0.001), and shorter ICU (median=7.2 days,IQR: 5.5-9.8 vs. median=9.3 days, IQR: 6.0-17.2) and hospital stays (median=20.9 days, IQR: 17.0-28.5 vs. median=50.9 days,IQR: 35.9-80.0; P <0.001) compared to delayed recovery. Delayed recovery was independently and significantly associated with lower mean MQS (odds ratio [OR] = 0.51, 95% CI: 0.37 to 0.68, P <0.001) and lower highest IMS (OR=0.86, 95% CI: 0.75 to 0.96, P=0.001), whereas no significant associations with any rehabilitation parameters were found in the early recovery group. Conclusions::Higher rehabilitation dose and intensity during ICU stay were associated with a reduced risk of delayed ADL recovery. Optimizing these parameters may improve functional outcomes in critically ill patients. These findings should be interpreted with caution, as the analysis was post hoc and exploratory in nature.