Exercise therapy (ET) is increasingly recognized as a vital intervention for preventing and managing Post-Intensive Care Syndrome (PICS), a complex condition affecting physical, cognitive, and mental functions in ICU survivors. This review summarizes current evidence on the role of ET in ICU and post-discharge settings, highlighting its effectiveness in improving outcomes for patients. PICS is a growing public health concern, with many ICU survivors experiencing long-term disabilities that significantly impact their quality of life. ET, defined as any physical activity that aids in maintaining or improving muscle strength and function, has shown promise in mitigating the effects of ICU-acquired weakness (ICUAW) and other impairments. ET is delivered in various forms, including passive, assisted, and active interventions, and is crucial for early rehabilitation. However, its implementation in ICUs remains challenging due to factors such as ICU culture, lack of funding, and insufficient training. The review emphasizes the importance of a multidisciplinary approach to ensure safe and effective ET delivery. Emerging technologies, such as virtual reality and robotics, are being explored to enhance ET delivery, especially for patients who cannot participate in traditional rehabilitation. ET also has positive effects on cognitive and mental health, reducing delirium, improving mood, and enhancing social interaction. The review discusses the mechanisms through which ET promotes recovery, including improved cerebral perfusion, neurogenesis, and neuroplasticity. Additionally, it highlights the need for personalized and individualized approaches to ET, considering the heterogeneity of ICU patients. Future research should focus on optimizing ET dosing, integrating it with other interventions, and developing targeted strategies for different patient groups. The review also addresses the importance of post-ICU follow-up and the role of telehealth in facilitating continued rehabilitation. Overall, ET is a key component in the rehabilitation of ICU survivors, helping them regain their pre-illness function and improve their quality of life.Exercise therapy (ET) is increasingly recognized as a vital intervention for preventing and managing Post-Intensive Care Syndrome (PICS), a complex condition affecting physical, cognitive, and mental functions in ICU survivors. This review summarizes current evidence on the role of ET in ICU and post-discharge settings, highlighting its effectiveness in improving outcomes for patients. PICS is a growing public health concern, with many ICU survivors experiencing long-term disabilities that significantly impact their quality of life. ET, defined as any physical activity that aids in maintaining or improving muscle strength and function, has shown promise in mitigating the effects of ICU-acquired weakness (ICUAW) and other impairments. ET is delivered in various forms, including passive, assisted, and active interventions, and is crucial for early rehabilitation. However, its implementation in ICUs remains challenging due to factors such as ICU culture, lack of funding, and insufficient training. The review emphasizes the importance of a multidisciplinary approach to ensure safe and effective ET delivery. Emerging technologies, such as virtual reality and robotics, are being explored to enhance ET delivery, especially for patients who cannot participate in traditional rehabilitation. ET also has positive effects on cognitive and mental health, reducing delirium, improving mood, and enhancing social interaction. The review discusses the mechanisms through which ET promotes recovery, including improved cerebral perfusion, neurogenesis, and neuroplasticity. Additionally, it highlights the need for personalized and individualized approaches to ET, considering the heterogeneity of ICU patients. Future research should focus on optimizing ET dosing, integrating it with other interventions, and developing targeted strategies for different patient groups. The review also addresses the importance of post-ICU follow-up and the role of telehealth in facilitating continued rehabilitation. Overall, ET is a key component in the rehabilitation of ICU survivors, helping them regain their pre-illness function and improve their quality of life.