Effect of supervised aerobic exercise rehabilitation on physical fitness and quality-of-life in survivors of critical illness: an exploratory minimized controlled trial (PIX study)
Open accessAbstract
BACKGROUND: Evidence is limited for the effectiveness of interventions for survivors of critical illness after hospital discharge. We explored the effect of an 8-week hospital-based exercise-training programme on physical fitness and quality-of-life. METHODS: In a parallel-group minimized controlled trial, patients were recruited before hospital discharge or in the intensive care follow-up clinic and enrolled 8-16 weeks after discharge. Each week, the intervention comprised two sessions of physiotherapist-led cycle ergometer exercise (30 min, moderate intensity) plus one equivalent unsupervised exercise session. The control group received usual care. The primary outcomes were the anaerobic threshold (in ml O2 kg(-1) min(-1)) and physical function and mental health (SF-36 questionnaire v.2), measured at Weeks 9 (primary time point) and 26. Outcome assessors were blinded to group assignment. RESULTS: Thirty patients were allocated to the control and 29 to the intervention. For the anaerobic threshold outcome at Week 9, data were available for 17 control vs 13 intervention participants. There was a small benefit (vs control) for the anaerobic threshold of 1.8 (95% confidence interval, 0.4-3.2) ml O2 kg(-1) min(-1). This advantage was not sustained at Week 26. There was evidence for a possible beneficial effect of the intervention on self-reported physical function at Week 9 (3.4; -1.4 to 8.2 units) and on mental health at Week 26 (4.4; -2.4 to 11.2 units). These potential benefits should be examined robustly in any subsequent definitive trial. CONCLUSIONS: The intervention appeared to accelerate the natural recovery process and seems feasible, but the fitness benefit was only short term. CLINICAL TRIAL REGISTRATION: Current Controlled Trials ISRCTN65176374 (http://www.controlled-trials.com/ISRCTN65176374).
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Four observational studies examined the impact of peer support groups on ICU patients, though they were not specific to sepsis patients.
“Four observational studies examined the impact of peer support groups on ICU patients, though they were not specific to sepsis patients.”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [554]
The Methods (Participants and sample size; page unavailable) describe an exploratory trial of ICU survivors admitted for trauma or sepsis, not an observational study of peer support groups. The Discussion (page unavailable) identifies the intervention as exercise. Our copy does not report four observational studies of peer support groups. (LLM, conf=0.86)
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Experimental — accuracy not yet measuredSeveral randomised studies have assessed physical rehabilitation programmes for survivors of critical illness.
“Several randomised studies have assessed physical rehabilitation programmes for survivors of critical illness [581, 606, 644–651].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [644]
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- Authors
- Batterham, A. M., Bonner, S., Wright, J., Howell, S. J., Hugill, K., & Danjoux, G.
- Affiliations
- Teesside University (GB)
- James Cook University Hospital (GB)
- University of Leeds (GB)
- Corresponding author
- Danjoux, G.
- Venue
- British Journal of Anaesthesia
- Publisher
- Elsevier BV
- Published
- 2014-07
- Volume
- 113
- Issue
- 1
- Pages
- 130-137
- ISSN
- 0007-0912 (ISSN-L)
- PMC
- PMC4062299
- OpenAlex
- W2120267076
- Cited by
- 92
- References
- 33
- Citations by year
- 2026: 11 · 2025: 11 · 2024: 3 · 2023: 8 · 2022: 3 · 2021: 8 · 2020: 4 · 2019: 10 · 2018: 6 · 2017: 9 · 2016: 9 · 2015: 5 · 2014: 5
- FWCI
- 7.51
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Anaesthesia (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- TeesRep (Teesside University) (acceptedVersion, cc-by-nc-nd)
- Teesside University Research Portal (Teesside University) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health and Care Research (PB-PG-0407-13274, PB-PG-1111-26068)
- Medical Research Council (MR/K02325X/1)
- Research for Patient Benefit Programme
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- critical illness survivors, post-intensive care syndrome, exercise rehabilitation, physical fitness, quality of life, anaerobic threshold, physical function, mental health, cycle ergometry, physiotherapy, hospital discharge
- MeSH terms
- Adolescent, Adult, Aged, Exercise Test, Exercise Therapy, Female, Humans, Intensive Care Units, Male, Middle Aged, Physical Fitness, Psychometrics, Quality of Life, Anaerobic Threshold, Single-Blind Method, Critical Illness, Treatment Outcome, Young Adult
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