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Objective To investigate the effect of early activity combined with electrical stimulation of neuromuscular system in improving intensive care unit (ICU)-acquired weakness (ICU-AW) patients with severe pneumonia. Methods A total of 150 patients with ICU-AW caused by severe pneumonia admitted to emergency intensive care unit(EICU) in a tertiary hospital in Shanghai were enrolled as the study subjects, and randomly divided into control group (75 cases) and combined group (75 cases). The control group took early exercise, and the combination group was given early exercise plus electrical stimulation of neuromuscular system. The recovery from mechanical ventilation (ICU length of stay, duration of mechanical ventilation, weaning extubation rate, ICU rollout rate), lung function [forced vital capacity (FVC), forced expiratory volume in the 1 s (FEV1)/FVC, massive inspiratory pressure (MIP)],muscle strength[Medical Research Council (MRC) score], disease severity[acute physiology and chronic health evaluation II (APACHE II)], and complications were compared between the two groups. Results The ICU length of stay and mechanical ventilation time in the combined group were significantly lower than those in the control group (P＜0.05). After intervention, FVC, FEV1/FVC, MIP and MRC scores in the two groups were significantly increased(P＜0.05), and compared with the control group, the combined group was significantly increased(P＜0.05). After intervention, APACHE II score was significantly reduced in the two groups(P＜0.05), and compared with the control group, APACHE II score in combined group were significantly reduced (P＜0.05). The complication rate in the combined group (9.33%) was significantly lower than that of control group (24.00%) (P＜0.05). Conclusions Early exercise combined with neuromuscular electrical stimulation in patients with severe pneumonia ICU-AW can effectively promote recovery of patients because of improved lung function. This therapy is proved to be be safe and effective. [ABSTRACT FROM AUTHOR]