Post-Acute Rehabilitation After Critical Illness and Major Trauma: Linking Neurocognitive, Behavioural, and Musculoskeletal Recovery

Survival from critical illness, major trauma, and stroke is increasingly common, but recovery is frequently incomplete. A substantial proportion of patients develop persistent impairments that span the neurocognitive, behavioural, and musculoskeletal domains — a clinical picture well documented under frameworks such as Post-Intensive Care Syndrome (PICS), Intensive Care Unit (ICU)-acquired weakness, post-stroke disability and severe trauma- or surgery-related functional decline. These conditions share specific, intermingling features: a defined acute precipitating event, prolonged immobilisation and catabolic stress, neuroinflammation and neuromuscular dysfunction, and a recovery trajectory in which cognitive and physical impairments evolve together and influence each other over time.

This Research Topic focuses on the post-acute rehabilitation phase of such populations. It is grounded in the observation that, in this specific clinical context, neurocognitive, behavioural, and musculoskeletal recovery cannot be addressed in isolation: mobility impairments and deconditioning constrain cognitive engagement in rehabilitation; cognitive impairment, fatigue, mood disturbance, and altered illness perceptions limit adherence to physical rehabilitation; and behavioural factors such as fear-avoidance, low self-efficacy, and maladaptive coping shape long-term functional outcomes. The aim is therefore to consolidate evidence on the mechanisms — both pathophysiological and psychological — that link these domains, and to advance integrated, function-oriented rehabilitation models with measurable outcomes.

We welcome contributions that:

- Characterise the trajectories and predictors of combined cognitive–behavioural–musculoskeletal impairment after critical illness, major trauma, and/or stroke.
- Investigate biological mechanisms (e.g., neuroinflammation, neuromuscular dysfunction, autonomic dysregulation, sarcopenia following catabolic stress) underpinning combined impairment.
- Examine psychological and behavioural mechanisms (illness perceptions, fear-avoidance, coping, self-efficacy, mood, cognitive appraisal) that contribute to persistent overall disability and rehabilitation response.
- Evaluate integrated rehabilitation interventions that address physical and cognitive recovery jointly, including multidisciplinary programmes, early mobilisation strategies, and combined cognitive–motor training.
- Develop and validate outcome measures, prognostic models, or digital/AI-based monitoring tools — provided they are anchored to clearly defined patient populations and clinically meaningful endpoints.

Accepted article types include original research, clinical trials, systematic reviews, meta-analyses, and brief research reports. Narrative reviews and clinical case reports will be considered only when they contribute distinctive conceptual or methodological value.

Conflict of Interest Statement:

Dr. Andreea-Iulia Vlădulescu-Trandafir has received congress registration fees and accommodation support from Eli Lilly and Novartis.

Prof. Gelu Onose holds multiple patents and registered design models (Nos. 113428, 122177, 123160, RO 2011 00006, RO 2013 00063, 023606, 023669) issued by OSIM/SOIM, covering orthotic devices, medical data management systems, and graphical interfaces.

Assist. Prof. Cristina Popescu has received congress registration fees (2 years) and congress accommodation support (1 year) from LaborMed Pharma Trading S.R.L., and a one-time speaker fee from Secom.

Dr. Sara Laxe has received sponsorship to attend congresses from Ipsen, Novo Nordisk, and Viatris, and other companies.

Prof. Otilia Rogoveanu declares no competing interests.