Exercise-based rehabilitation after hospital discharge for survivors of critical illness with intensive care unit–acquired weakness: A pilot feasibility trial

Abstract Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with...

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Bibliographic Details
Published in:	Journal of critical care 2015-06, Vol.30 (3), p.589-598
Main Authors:	Connolly, Bronwen, PhD, Thompson, April, Douiri, Abdel, Moxham, John, Hart, Nicholas
Format:	Article
Language:	eng
Subjects:	Aged Clinical Potpourri Clinical trials Cohort Studies Critical Care Critical illness Critical Illness - rehabilitation Exercise rehabilitation Exercise Therapy - methods Feasibility Studies Female Hospital discharge Hospitals Humans Illnesses Intensive care Intensive Care Units Intensive care unit–acquired weakness Male Middle Aged Muscle Weakness - etiology Muscle Weakness - rehabilitation Patient Discharge Pilot Projects R&D Rehabilitation Research & development Studies Survivors Ventilation
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Summary:	Abstract Purpose The aim of this study was to investigate feasibility of exercise-based rehabilitation delivered after hospital discharge in patients with intensive care unit–acquired weakness (ICU-AW). Materials and methods Twenty adult patients, mechanically ventilated for more than 48 hours, with ICU-AW diagnosis at ICU discharge were included in a pilot feasibility randomized controlled trial receiving a 16-session exercise-based rehabilitation program. Twenty-one patients without ICU-AW participated in a nested observational cohort study. Feasibility, clinical, and patient-centered outcomes were measured at hospital discharge and at 3 months. Results Intervention feasibility was demonstrated by high adherence and patient acceptability, and absence of adverse events, but this must be offset by the low proportion of enrolment for those screened. The study was underpowered to detect effectiveness of the intervention. The use of manual muscle testing for the diagnosis of ICU-AW lacked robustness as an eligibility criterion and lacked discrimination for identifying rehabilitation requirements. Process evaluation of the trial identified methodological factors, categorized by “population,” “intervention,” “control group,” and “outcome.” Conclusions Important data detailing the design, conduct, and implementation of a multicenter randomized controlled trial of exercise-based rehabilitation for survivors of critical illness after hospital discharge have been reported. Registration Clinical Trials Identifier NCT00976807
ISSN:	0883-9441 1557-8615