Effectiveness of a Structured Multidimensional Tele-rehabilitation Intervention in Cardiac Patients With Post-Intensive Care Syndrome (CARDIO-PICS)

Inclusion Criteria: * Adults aged 30-75 years * Previous ICU admission ≥48 hours * Presence of Post-Intensive Care Syndrome (PICS), defined as at least one of the following objectively assessed impairments at baseline (T0): * Neuromotor impairment, defined as Diagnosis of Critical Illness Myopathy (CIM) or Critical Illness Polyneuropathy (CIP), confirmed by electromyography (EMG) * Cognitive impairment, defined as Montreal Cognitive Assessment (MoCA) score \< 26 * Psychological impairment, defined as Patient Health Questionnaire-9 (PHQ-9) score ≥ 10 * Nutritional impairment, defined as the presence of malnutrion according to GLIM criteria, requiring at least one phenotypic criterion (non-volitional weight loss \>5% within 6 months or \>10% beyond 6 months; BMI \<20 kg/m² if \<70 years or \<22 kg/m² if ≥70 years; reduced muscle mass) and at least one etiologic criterion (reduced food intake or assimilation for \>1 week, or any acute/chronic inflammatory burden) and/or presence of sarcopenia assessed by calf circumference \<31 cm and reduced muscle strength measured by handgrip strength * Metabolic or bone metabolism disorder, defined as altered bone metabolism markers (Bone Turnover Markers outside reference range) Ability to provide written informed consent Exclusion Criteria * Prognostically unfavorable malnutrition defined as: CONUT score ≥5. * Delirium present at the time of the enrollment, documented by a positive Confusion Assessment Method (CAM or CAM-ICU) * Pre-existing severe cognitive impairment or dementia, defined as: documented diagnosis in the medical record prior to ICU admission \- Any clinical condition limiting participation in the rehabilitation program, including: severe orthopedic, neurological, or functional limitations not related to PICS