Abstract
Purpose
To investigate feasibility of exercise-based rehabilitation delivered following 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 randomised controlled trial receiving a sixteen-session exercise-based rehabilitation programme. Twenty-one patients without ICU-AW participated in a nested observational cohort study. Feasibility, clinical and patient-centred outcomes were measured at hospital discharge and at three 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, categorised by the ‘Population’, ‘Intervention’, ‘Control Group’ and ‘Outcome’.
Conclusions
Important data detailing the design, conduct and implementation of a multicentre randomised controlled trial of exercise-based rehabilitation for survivors of critical illness following hospital discharge have been reported.
To investigate feasibility of exercise-based rehabilitation delivered following 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 randomised controlled trial receiving a sixteen-session exercise-based rehabilitation programme. Twenty-one patients without ICU-AW participated in a nested observational cohort study. Feasibility, clinical and patient-centred outcomes were measured at hospital discharge and at three 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, categorised by the ‘Population’, ‘Intervention’, ‘Control Group’ and ‘Outcome’.
Conclusions
Important data detailing the design, conduct and implementation of a multicentre randomised controlled trial of exercise-based rehabilitation for survivors of critical illness following hospital discharge have been reported.
| Original language | English |
|---|---|
| Pages (from-to) | 589-598 |
| Number of pages | 10 |
| Journal | Journal of Critical Care |
| Volume | 30 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 2015 |